Individual provider Active NPI

Debra L Merrifield, PSY.D.

  • Clinical Psychologist
  • Glendale, AZ
National Provider Identifier
1154540433
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1747 Issued in AZ
Practice address
4915 W Bell Rd
Suite 202
Glendale, AZ 85308
Phone
(602) 852-0911
Fax
(602) 938-6640
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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 1747 AZ Primary

Addresses

Primary practice location

4915 W Bell Rd
Suite 202
Glendale, AZ 85308

Mailing address

4915 W Bell Rd
Suite 202
Glendale, AZ 85308-3425
Phone (029) 420-2526

Other practice location 1

4222 E Camelback Rd
Suite 230-H
Phoenix, AZ 85018-2745
Phone (602) 852-0911

Other identifiers 2

IdentifierTypeStateIssuer
1154540433OtherAZNPI
1747OtherAZLICENSE

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

State licenses

LicenseStateTypeSpecialty
1747AZMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1154540433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 W BELL RD",
            "address_2": "SUITE 202",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083425",
            "telephone_number": "029-420-2526",
            "fax_number": "602-938-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 W BELL RD",
            "address_2": "SUITE 202",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "602-852-0911",
            "fax_number": "602-938-6640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4222 E Camelback Rd",
            "address_2": "Suite 230-H",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850182745",
            "country_code": "US",
            "telephone_number": "602-852-0911",
            "fax_number": "602-852-0632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRIFIELD",
        "first_name": "DEBRA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "1747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1154540433",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1747",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.