Active NPI
Michael D Rabara, PSYD
- Clinical Psychologist
- Phoenix, AZ
National Provider Identifier
1346890308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY-003645
- Practice address
- 1450 E Indian School Rd Ste 106
Phoenix, AZ 85014-4954 - Phone
- (602) 325-3443
- NPI assigned
- Sep 12, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1354 | HI | |
| Clinical Psychologist | 103TC0700X | PSY-003645 | AZ | Primary |
Addresses
Primary practice location
1450 E Indian School Rd Ste 106
Phoenix, AZ 85014-4954
Mailing address
1450 E Indian School Rd Ste 106
Phoenix, AZ 85014-4954
Phone (602) 325-3443
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-003645 | AZ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568246400000",
"number": "1346890308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 E INDIAN SCHOOL RD STE 106",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850144954",
"telephone_number": "602-325-3443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 E INDIAN SCHOOL RD STE 106",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850144954",
"telephone_number": "602-325-3443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RABARA",
"first_name": "MICHAEL",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-12",
"last_updated": "2019-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "1354",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "PSY-003645",
"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 Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.