Niloufer Moiz Merchant, ED.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3296 Issued in MN

Practice address

22 Wilson Ave NE
Suite 110
Saint Cloud, MN 56304-0440

Phone

(320) 251-7700

NPI assigned

Apr 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lutheran Social Service of Minnesota

  • Community/Behavioral Health Agency
  • Saint Cloud, MN
  • NPI 1629192430
  NPD (past)

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1215154133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 MONROE PL",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031652",
            "telephone_number": "320-253-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WILSON AVE NE",
            "address_2": "SUITE 110",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563040440",
            "telephone_number": "320-251-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Doctors Park",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563031207",
            "country_code": "US",
            "telephone_number": "320-316-0300",
            "fax_number": "320-281-3045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "NILOUFER",
        "middle_name": "MOIZ",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273694000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Neal Mellinger, DO
• Cinda Jensen Melloy, MD
• Memory Care Clinic
• Memory Disorders Clinic
• Shannon Menth, MSN, RN, ARNP, CNP
• Albert Joseph Mercuri, MD
• Merls Transportation
• Genife Gera Merrell
• Carol Sybella Merriman, MS LP LICSW
• Heather J Merritt, RD

• Psychologist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.