Individual provider Active NPI

Melinda Carole Losee, PH.D.

  • Clinical Psychologist
  • Cody, WY
National Provider Identifier
1114078383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
319 Issued in WY
Practice address
2 Rangeview Dr
Cody, WY 82414-8889
Phone
(307) 587-7877
Fax
(307) 587-7877
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 319 WY Primary

Addresses

Primary practice location

2 Rangeview Dr
Cody, WY 82414-8889

Mailing address

2 Rangeview Dr
Cody, WY 82414-8889
Phone (307) 587-7877

Other identifiers 1

IdentifierTypeStateIssuer
117464902MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080718000556 WA Practitioner - Clinical Psychologist 7214000579 Practice locations: Olympia, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
319WYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114078383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RANGEVIEW DR",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824148889",
            "telephone_number": "307-587-7877",
            "fax_number": "307-587-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 RANGEVIEW DR",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824148889",
            "telephone_number": "307-587-7877",
            "fax_number": "307-587-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOSEE",
        "first_name": "MELINDA",
        "middle_name": "CAROLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WY",
            "license": "319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117464902",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

Sources for this page

Verify at the official NPI Registry.