Provider Demographics
NPI:1912934944
Name:MANCUSO, APRIL LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:LYNN
Last Name:MANCUSO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 N HAMILTON RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-8703
Mailing Address - Country:US
Mailing Address - Phone:614-478-4900
Mailing Address - Fax:614-478-7575
Practice Address - Street 1:765 N HAMILTON RD
Practice Address - Street 2:SUITE 210
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-8703
Practice Address - Country:US
Practice Address - Phone:614-478-4900
Practice Address - Fax:614-478-7575
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3311103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP04632Medicare UPIN