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Deactivated NPI 1750438438 Deactivated / Inactive NPI Male Practitioner

Anthony Derosa

Psychologist - Clinical • Boardman, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Anthony Derosa has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 04, 2007
NPI Deactivation Date June 21, 2023
Total Practice Duration ~16 Years of Practice (2007 – 2023)

Professional Overview & Biography Verified Profile Summary

Anthony Derosa was a registered Psychologist - Clinical practicing in Boardman, OH. Throughout an active medical career spanning 16 years, Anthony Derosa provided care at the practice location at 997 BOARDMAN CANFIELD RD until profile deactivation on 2023-06-21.

Historical Medicare Part B clinical services included psychotherapy. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

997 Boardman Canfield Rd

Boardman, OH 445124223

Telephone 3307580101
Associated Practice Facility / Clinic
🏢 Psycare, Inc. Facility NPI 1073659603

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Boardman, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 24.7 Yrs
State Avg: 26.2 Yrs
Regional Practice Density
8 Specialists

Practicing in Boardman, OH (1691 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
25.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2020)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90837 Psychotherapy, 60 minutes
34 12 $185.00 $138.57

Medical Specialties & State Licenses

Psychologist - Clinical Primary Specialty

NUCC Taxonomy Code: 103TC0700X

State License OH 202

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Jill Mcfarland , MSED, LPCC-S

Counselor - Professional

NPI 1295874030

Master of Science in Education, LPCCS

Morghan Honthy , LPC

Counselor - Mental Health

NPI 1427575455

Licensed Professional Counselor

NPI 1427616556

Master of Education, LPCCS, LICDC

Adrian Waldron

Counselor - Professional

NPI 1477302545
NPI 1487251419

Master of Education, Licensed Professional Clinical Counselor

Tracey Vantassel , MSED, LPCC, LSW

Counselor - Professional

NPI 1699753350

Master of Science in Education, Licensed Professional Clinical Counselor, Licensed Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 21, 2023

Record deactivated on June 21, 2023

NPI Profile Active November 20, 2007

NPI status registered as active in NPPES database

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Updated Practice Location November 20, 2007

Registered at 997 BOARDMAN CANFIELD RD, BOARDMAN, OH 445124223 (Tel: 3307580101)

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Updated Business Mailing Address November 20, 2007

Registered at 8577 E MARKET ST, WARREN, OH 444842345 (Tel: 3308566663)

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Provider Name / Credentials Updated November 20, 2007

Recorded as ANTHONY DEROSA

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 20, 2007

Psychologist (License #202 in OH)

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Initial NPI Registration & Enumeration January 04, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1750438438
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 04, 2007
Last Update: November 20, 2007
Deactivation Date: June 21, 2023

Mailing Address

8577 E Market St

Warren, OH 444842345

Phone: 3308566663

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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