Active NPI
Karen Mansfield-Blair, PHD
- Clinical Psychologist
- Goodyear, AZ
National Provider Identifier
1629469135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3950
- Practice address
- 15655 W Roosevelt St
Suite 243
Goodyear, AZ 85338-9282 - Phone
- (623) 242-7393
- Fax
- (480) 659-7230
- NPI assigned
- Feb 5, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3950 | AZ | Primary |
Addresses
Primary practice location
15655 W Roosevelt St
Suite 243
Goodyear, AZ 85338-9282
Mailing address
15655 W Roosevelt St
Suite 243
Goodyear, AZ 85338-9282
Phone (623) 242-7393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3950 | Other | AZ | STATE OF ARIZONA |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3950 | AZ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1629469135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15655 W ROOSEVELT ST",
"address_2": "SUITE 243",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853389282",
"telephone_number": "623-242-7393",
"fax_number": "480-659-7230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15655 W ROOSEVELT ST",
"address_2": "SUITE 243",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853389282",
"telephone_number": "623-242-7393",
"fax_number": "480-659-7230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSFIELD-BLAIR",
"first_name": "KAREN",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-05",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "3950",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF ARIZONA",
"identifier": "3950",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.