MEDICARE: DR. WENDY S DEGILIO PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS015694	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2679863000	OTHER	PA	INDEPENDENCE BC
2	828759000	OTHER	PA	MAGELLAN
3	LA1804248	OTHER	PA	HIGHMARK
4	50056293	OTHER	PA	CAPITAL BC

General Provider Information

NPI Number	:	1053398651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDY S DEGILIO PSY.D.

Provider Business Mailing Address
First Line	:	20 EAGLES VIEW DR
Second Line	:
City	:	NEW RINGGOLD
State	:	PA
Zip	:	17960-9409
Country	:	US
Telephone Number	:	570-657-5484
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 EAGLES VIEW DR
Second Line	:
City	:	NEW RINGGOLD
State	:	PA
Zip	:	17960-9409
Country	:	US
Telephone Number	:	570-657-5484
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	10/09/2025

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