Individual provider Active NPI

Marisa Menchola, PH.D.

  • Clinical Psychologist
  • Tucson, AZ
National Provider Identifier
1134439961
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4142 Issued in AZ
Practice address
2626 E River Rd
Tucson, AZ 85718-6632
Phone
(520) 694-7021
NPI assigned
Oct 14, 2010
Last updated
Feb 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 4142 AZ
Clinical Psychologist 103TC0700X 4142 AZ Primary

Addresses

Primary practice location

2626 E River Rd
Tucson, AZ 85718-6632

Mailing address

7028 E Calle Hermosa
Tucson, AZ 85715-4912
Phone (520) 270-1814

Other practice location 1

6019 E Grant Rd
Tucson, AZ 85712-2316
Phone (520) 352-9955

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101227000833 AZ Practitioner - Clinical Psychologist 4981892429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

3838 N Campbell Ave
BLDG 2
Tucson, AZ 85719-1454
Phone (520) 694-8888

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Jan 26, 2026 Accepting new patients
Neuropsychology LTD Clinical Neuropsychologist Past Accepting new patients

Locations

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

2800 E Ajo Way
Bldg 100
Tucson, AZ 85713
Phone (520) 419-5820

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

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": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1134439961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7028 E CALLE HERMOSA",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857154912",
            "telephone_number": "520-270-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186632",
            "telephone_number": "520-694-7021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6019 E Grant Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122316",
            "country_code": "US",
            "telephone_number": "520-352-9955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENCHOLA",
        "first_name": "MARISA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "4142",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.