Individual provider Active NPI

Meredith L. Gilbert, PH.D.

  • Clinical Psychologist
  • Mercer Island, WA
National Provider Identifier
1407055619
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00003681 Issued in WA
Practice address
3035 Island Crest Way
Suite 112
Mercer Island, WA 98040-2919
Phone
(206) 232-2898
Fax
(206) 382-0245
NPI assigned
Jul 17, 2007
Last updated
Jul 17, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH00009339 WA
Adult Development & Aging Psychologist 103TA0700X PY00003681 WA
Cognitive & Behavioral Psychologist 103TB0200X PY00003681 WA
Clinical Psychologist 103TC0700X PY00003681 WA Primary
Group Psychotherapy Psychologist 103TP2701X PY00003681 WA

Addresses

Primary practice location

3035 Island Crest Way
Suite 112
Mercer Island, WA 98040-2919

Mailing address

3035 Island Crest Way
Suite 112
Mercer Island, WA 98040-2919
Phone (206) 232-2898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100325000283 WA Practitioner - Clinical Psychologist 1254467616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3035 Island Crest Way
Suite 112
Mercer Island, WA 98040-2919
Phone (206) 232-2898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LH00009339WAMDMental Health Counselor
PY00003681WAMDAdult Development & Aging Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Divorce Options, P.S. CurrentSince Sep 4, 2013 Accepting new patients

Locations

3035 Island Crest Way
Ste 112
Mercer Island, WA 98040
Phone (206) 232-2898

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1407055619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 ISLAND CREST WAY",
            "address_2": "SUITE 112",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402919",
            "telephone_number": "206-232-2898",
            "fax_number": "206-382-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 ISLAND CREST WAY",
            "address_2": "SUITE 112",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402919",
            "telephone_number": "206-232-2898",
            "fax_number": "206-382-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "MEREDITH",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00009339",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "WA",
            "license": "PY00003681",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WA",
            "license": "PY00003681",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003681",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "WA",
            "license": "PY00003681",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

Verify at the official NPI Registry.