Active NPI
Marley Wayne Watkins, PH.D.
- School Psychologist
- Phoenix, AZ
National Provider Identifier
1275746653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 835
- Practice address
- 2813 W Amberwood Dr
Phoenix, AZ 85045-4211 - Phone
- (480) 284-5128
- NPI assigned
- May 8, 2007
- Last updated
- Jun 22, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 835 | AZ | Primary |
| School Psychologist | 103TS0200X | PS008382L | PA |
Addresses
Primary practice location
2813 W Amberwood Dr
Phoenix, AZ 85045-4211
Mailing address
2813 W Amberwood Dr
Phoenix, AZ 85045-4211
Phone (480) 284-5128
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 |
|---|---|---|---|
| 835 | AZ | MD | School Psychologist |
| PS008382L | PA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277164800000",
"number": "1275746653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2813 W AMBERWOOD DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850454211",
"telephone_number": "480-284-5128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2813 W AMBERWOOD DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850454211",
"telephone_number": "480-284-5128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "MARLEY",
"middle_name": "WAYNE",
"name_prefix": "Prof.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2010-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "AZ",
"license": "835",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "PA",
"license": "PS008382L",
"primary": false
}
],
"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 Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.