Provider Demographics
NPI:1902251341
Name:MACEACHRON, DEVON BYARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:BYARD
Last Name:MACEACHRON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 E 77TH ST
Mailing Address - Street 2:7C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1860
Mailing Address - Country:US
Mailing Address - Phone:646-612-0328
Mailing Address - Fax:
Practice Address - Street 1:71 E 77TH ST
Practice Address - Street 2:7C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1860
Practice Address - Country:US
Practice Address - Phone:646-612-0328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020631-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist