Organization Active NPI

Volusia Neuropsychology & Behavioral Health Inc

  • Clinical Neuropsychologist
  • New Smyrna Beach, FL
National Provider Identifier
1033313903
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY6889 Issued in FL
Legal business name
VOLUSIA NEUROPSYCHOLOGY & BEHAVIORAL HEALTH INC
Practice address
221 N Causeway
Suite B
New Smyrna Beach, FL 32169-5298
Phone
(386) 423-0442
Fax
(386) 423-0402
NPI assigned
Jun 13, 2007
Last updated
Aug 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Authorized official

Name
Dr. Lisa Sundvall Merilson, PSY.D.NPI 1932140175
Title
Psychologist
Phone
(386) 423-0442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY6889 FL Primary
Cognitive & Behavioral Psychologist 103TB0200X PY6889 FL

Addresses

Primary practice location

221 N Causeway
Suite B
New Smyrna Beach, FL 32169-5298

Mailing address

221 N Causeway
Suite B
New Smyrna Beach, FL 32169-5298
Phone (386) 423-0442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040612000336 FL Part B Supplier - Clinic/Group Practice 0244213874 Receives reassigned benefits from 6 practitioners
Practice locations: New Smyrna Beach, FL

National Provider Directory

National Provider Directory

Locations

140 S Beach St
Ste 405
Daytona Beach, FL 32114
Phone (386) 822-9943

221 N Causeway
#B
New Smyrna Beach, FL 32169
Phone (386) 423-0442

221 N Causeway
Ste B
New Smyrna Beach, FL 32169
Phone (386) 423-0442

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1033313903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 N CAUSEWAY",
            "address_2": "SUITE B",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321695298",
            "telephone_number": "386-423-0442",
            "fax_number": "386-423-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 N CAUSEWAY",
            "address_2": "SUITE B",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321695298",
            "telephone_number": "386-423-0442",
            "fax_number": "386-423-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOLUSIA NEUROPSYCHOLOGY & BEHAVIORAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "MERILSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "SUNDVALL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "386-423-0442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY6889",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY6889",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.