Active NPI
Patricia Lavallee, C.A.G.S
- School Psychologist
- Glendale, AZ
National Provider Identifier
1508401266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 6128 W McRae Way
Glendale, AZ 85308-7635 - Phone
- (401) 744-7543
- NPI assigned
- Nov 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | |||
| School Psychologist | 103TS0200X | Primary |
Addresses
Primary practice location
6128 W McRae Way
Glendale, AZ 85308-7635
Mailing address
6128 W McRae Way
Glendale, AZ 85308-7635
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573862400000",
"number": "1508401266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6128 W MCRAE WAY",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853087635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6128 W MCRAE WAY",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853087635",
"telephone_number": "401-744-7543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVALLEE",
"first_name": "PATRICIA",
"credential": "C.A.G.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-16",
"last_updated": "2019-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.