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DR. ALLISON MARIE DEATHERAGE PHD
NPI 1659585099
Psychologist - Clinical in Charleston Afb, SC

Active since May 09, 2007
204 W HILL BLVD, CHARLESTON AFB, SC 29404(843) 963-6852 Get Directions Write a Review

NPPES record last updated: November 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 20, 2020, Jun 10, 2017, Jun 15, 2016 (3 updates tracked since 2016).

About Dr. Allison Marie Deatherage Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ALLISON MARIE DEATHERAGE PHD (NPI 1659585099) is an individual clinical provider in Charleston Afb, South Carolina, licensed in Ohio (7351) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1659585099
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. ALLISON MARIE DEATHERAGECredential: PHD
Location Address204 W HILL BLVDCharleston Afb, SC 29404-4704
Mailing AddressPo Box 21467Columbus, OH 43221-0467 · (614) 380-9371
Phone(843) 963-6852
Sole ProprietorYes
Enumeration DateMay 9, 2007
Last NPPES UpdateNovember 20, 20203 updates tracked since enumeration
NPPES CertifiedNovember 20, 2020
✔ NPI 1659585099 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in OH · 7351
Definition
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.
204 W HILL BLVD, Charleston Afb, SC 29404
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Other Identifiers 1

Medicaid2614899OH

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNITED STATES AIR FORCE
Clinic/Center
204 W HILL BLVD
CHARLESTON AFB, SC 29404
Charleston County (843) 963-6936
MR. CHAD ROBERT WILLIAMS LCSW
Social Worker (Clinical)
204 W HILL BLVD
CHARLESTON AFB, SC 29404
Charleston County (843) 963-6852
DR. CHANTELL RENEE MCKEE M.D.
Family Medicine
204 W HILL BLVD
CHARLESTON AFB, SC 29404
Charleston County (843) 963-6880
THI NGUYEN
Pharmacist
204 W HILL BLVD, 628TH MEDICAL GROUP
CHARLESTON AFB, SC 29404
Charleston County (843) 963-6808
RONNIE LEE GODBOLT IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
204 W HILL BLVD
CHARLESTON AFB, SC 29404
Charleston County (843) 963-6936
VIRGINIA BULLEMAN LISW-CP
Social Worker (Clinical)
204 W HILL BLVD
JOINT BASE CHARLESTON, SC 29404
Charleston County (843) 963-6880
SARA T HANSEN LISW-CP
Social Worker (Clinical)
204 W HILL BLVD
JOINT BASE CHARLESTON, SC 29404
Charleston County (843) 963-6880
DR. OSCAR ALEJANDRO LEYVA CAMACHO MD
Preventive Medicine (Aerospace Medicine)
204 W HILL BLVD
CHARLESTON AFB, SC 29404
Charleston County (843) 963-6722

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Allison Deatherage's NPI number?

The NPI number for Allison Deatherage is 1659585099. It was assigned to this individual provider in the NPPES registry on May 9, 2007.

Where is Allison Deatherage located?

Allison Deatherage practices at 204 W Hill Blvd, Charleston Afb, SC 29404. The listed phone number is (843) 963-6852.

What is Allison Deatherage's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Allison Deatherage was last updated on November 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.