Active NPI
Megan Gavin, PHD
- Psychologist
- Flagstaff, AZ
National Provider Identifier
1194550103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 004101
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 004101 | AZ | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Flagtown Therapy, LLC | Psychologist | Current | 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.
-
- Adolescent and Children Mental Health Clinic/Center
- Flagstaff, AZ
- NPI 1669117206
Psychologist
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.