Individual provider Active NPI

Jason Merrin, PHD

  • Psychologist
  • Wolfeboro Falls, NH
National Provider Identifier
1336388370
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS1302 Issued in ME
Practice address
35 Center St Unit 17
Wolfeboro Falls, NH 03896-7600
Phone
(603) 520-3797
NPI assigned
Feb 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS1302 ME Primary

Addresses

Primary practice location

35 Center St Unit 17
Wolfeboro Falls, NH 03896-7600

Mailing address

PO Box 455
Wolfeboro Falls, NH 03896-0455
Phone (603) 520-3797

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS1302MEMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Center PastSince May 1, 2006 Accepting new patients
Knada, PA PastSince Apr 1, 2018 Accepting new patients
Capital Valley Counseling Associates, Inc. PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1234742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1336388370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 455",
            "city": "WOLFEBORO FALLS",
            "state": "NH",
            "postal_code": "038960455",
            "telephone_number": "603-520-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CENTER ST UNIT 17",
            "city": "WOLFEBORO FALLS",
            "state": "NH",
            "postal_code": "038967600",
            "telephone_number": "603-520-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIN",
        "first_name": "JASON",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-16",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS1302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolfeboro Falls, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.