Individual provider Active NPI

Marisa Lynn Nava, PH.D.

  • Clinical Psychologist
  • Daniel Island, SC
National Provider Identifier
1003901307
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
959 Issued in SC
Practice address
260-C Seven Farms Dr.
Daniel Island, SC 29492
Phone
(843) 216-2968
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 959 SC Primary

Addresses

Primary practice location

260-C Seven Farms Dr.
Daniel Island, SC 29492

Mailing address

260-C Seven Farms. Dr.
Daniel Island, SC 29492
Phone (843) 216-2968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
959SCMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1003901307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260-C SEVEN FARMS. DR.",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "29492",
            "telephone_number": "843-216-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260-C SEVEN FARMS DR.",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "29492",
            "telephone_number": "843-216-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVA",
        "first_name": "MARISA",
        "middle_name": "LYNN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daniel Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.