Merrie Michal Elisens, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

833 Issued in OK

Practice address

222 Oliphant Ave
Suite 230
Norman, OK 73026-3701

Phone

(405) 329-8454

Fax

(405) 360-8193

NPI assigned

Jan 13, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1316098734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 SPRINGER DR",
            "address_2": "SUITE 230",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730693965",
            "telephone_number": "405-329-8454",
            "fax_number": "405-360-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 OLIPHANT AVE",
            "address_2": "SUITE 230",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730263701",
            "telephone_number": "405-329-8454",
            "fax_number": "405-360-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELISENS",
        "first_name": "MERRIE",
        "middle_name": "MICHAL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-13",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100837710-A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "189327",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Norman, OK
• Providers in Norman, OK by specialty
• Clinical Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.