Individual provider Active NPI

Megan Gavin, PHD

  • Psychologist
  • Flagstaff, AZ
National Provider Identifier
1194550103
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
004101 Issued in AZ
Practice address
16 E Route 66 Ste 203
Flagstaff, AZ 86001-5777
Phone
(928) 606-2907
NPI assigned
Sep 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 004101 AZ Primary

Addresses

Primary practice location

16 E Route 66 Ste 203
Flagstaff, AZ 86001-5777

Mailing address

624 W Tombstone Ave
Flagstaff, AZ 86001-5449
Phone (928) 266-3913

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
004101AZMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Flagtown Therapy, LLC Psychologist CurrentSince Sep 15, 2024 Accepting new patients

Locations

16 E Route 66
Ste 203
Flagstaff, AZ 86001
Phone (928) 606-2907

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1194550103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 W TOMBSTONE AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860015449",
            "telephone_number": "928-266-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E ROUTE 66 STE 203",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860015777",
            "telephone_number": "928-606-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "MEGAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "004101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.