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General NPI Number Information
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NPI Number | 1942321989
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Entity Type | Individual
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Provider Name | MASSIMO DE MARCHIS PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 732 BECKMAN ST NOVA HOUSE ASSOCIATION INC.
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City | DAYTON
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State | OH
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Zip | 45410-2165
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Country | US
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Telephone | 937-253-1680
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Fax | 937-253-8990
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Provider Business Mailing Address
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Address Line | 2536 ROANOKE AVE
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City | DAYTON
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State | OH
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Zip | 45419-1528
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Country | US
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Telephone | 937-684-2123
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Fax | 937-294-1830
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4045
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License Number State | OH
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