Elizabeth A Melles, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1438 Issued in OK

Practice address

310 W Keetoowah St
Tahlequah, OK 74464-3824

Phone

(918) 708-9558

Fax

(918) 708-9580

NPI assigned

Jul 20, 2023

Last updated

Jul 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Sonya L Cornwell PHD Clinical Psychologist PLLC

  • Clinical Psychologist
  • Tahlequah, OK
  • NPI 1417508904
  Medicare reassignment NPD

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1528748993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W KEETOOWAH ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643824",
            "telephone_number": "918-708-9558",
            "fax_number": "918-708-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W KEETOOWAH ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643824",
            "telephone_number": "918-708-9558",
            "fax_number": "918-708-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLES",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med-Trans Corporation
• Medic-Aire of Tahlequah, Inc.
• Alison Medina, PA-C
• Medwise LLC
• Melinda Shaver, Psy.D.
• Megan Melott Moss, DO
• Madison Danielle Mendoza
• Callie Merriott, DO
• Inga Merry, PHARMD
• Lisa Diane Meyers, MSN,ARNP-CNP,FNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.