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NPI 1053619874ActiveOrganization· Psychologist, Clinical· Scottsdale, AZ
Psychologist, Clinical in Scottsdale, Arizona, registered in NPPES in March 2011. The authorized official on file is Daniel E. Kostelnik, Vice President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1053619874 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 2, 2011 |
| Last updated in NPPES | Oct 17, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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