Individual provider Active NPI

Irvin Harvey Perline, PH.D.

  • Clinical Psychologist
  • Phoenix, AZ
National Provider Identifier
1205035722
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0249 Issued in AZ
Practice address
3131 E Camelback Rd
Suite 200
Phoenix, AZ 85016-4500
Phone
(480) 752-9410
Fax
(480) 752-9410
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 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 0249 AZ Primary

Addresses

Primary practice location

3131 E Camelback Rd
Suite 200
Phoenix, AZ 85016-4500

Mailing address

1753 E Broadway Rd
Suite 101-406
Tempe, AZ 85282-2081
Phone (480) 752-9410

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
0249AZMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1205035722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 E BROADWAY RD",
            "address_2": "SUITE 101-406",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822081",
            "telephone_number": "480-752-9410",
            "fax_number": "480-752-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 E CAMELBACK RD",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164500",
            "telephone_number": "480-752-9410",
            "fax_number": "480-752-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLINE",
        "first_name": "IRVIN",
        "middle_name": "HARVEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "0249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.