Individual provider Active NPI

Marissa L Mascorro, PSYD

  • Clinical Psychologist
  • Phoenix, AZ
National Provider Identifier
1063832343
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-005980 Issued in AZ
Practice address
2999 N 44TH St Ste 415
Phoenix, AZ 85018-7251
Phone
(602) 675-0335
Fax
(602) 865-8089
NPI assigned
Apr 24, 2014
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LAC-13710 AZ
Professional Counselor 101YP2500X LPC-17047 AZ
Clinical Psychologist 103TC0700X PSY-005980 AZ Primary

Addresses

Primary practice location

2999 N 44TH St Ste 415
Phoenix, AZ 85018-7251

Mailing address

2999 N 44TH St Ste 415
Phoenix, AZ 85018-7251
Phone (602) 675-0335

Other identifiers 1

IdentifierTypeStateIssuer
342848MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250516003238 AZ Practitioner - Psychiatry 3375061971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knapp NeuropsychologyGroup PAC ID 6709257959, 2 clinicians

Practice addresses (Care Compare)

2999 N 44TH St
Suite 415
Phoenix, AZ 85018-7251
Phone (602) 675-0335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC-13710AZMDMental Health Counselor
LPC-17047AZMDProfessional Counselor
PSY-005890AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Knapp Neuropsychology CurrentSince May 1, 2025 Accepting new patients
Arcadia Neuropsychology, PLLC CurrentSince May 1, 2025 Accepting new patients

Locations

2999 N 44th St
Ste 415
Phoenix, AZ 85018
Phone (480) 216-1789

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1063832343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 N 44TH ST STE 415",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187251",
            "telephone_number": "602-675-0335",
            "fax_number": "602-865-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 N 44TH ST STE 415",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187251",
            "telephone_number": "602-675-0335",
            "fax_number": "602-865-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCORRO",
        "first_name": "MARISSA",
        "middle_name": "L",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-13710",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-17047",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "PSY-005980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342848",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.