Individual provider Active NPI

Stephanie Merkey Slye, PSY.D.

  • Clinical Psychologist
  • Saint Joseph, MI
National Provider Identifier
1649356379
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013866 Issued in MI
Practice address
2500 Niles Rd Ste 5
Saint Joseph, MI 49085-3225
Phone
(269) 281-0408
Fax
(269) 281-4065
NPI assigned
Oct 27, 2006
Last updated
Dec 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P2980 TN
Clinical Psychologist 103TC0700X 016982 NY
Clinical Psychologist 103TC0700X 6301013866 MI Primary

Addresses

Primary practice location

2500 Niles Rd Ste 5
Saint Joseph, MI 49085-3225

Mailing address

2500 Niles Rd Ste 5
Saint Joseph, MI 49085-3225
Phone (269) 281-0408

Other names 1

  • Stephanie Meagan Merkey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130107000219 MI Practitioner - Clinical Psychologist 2365623949 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
George Washington University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axon Psychology Group, PCGroup PAC ID 6507286721, 4 clinicians

Practice addresses (Care Compare)

2500 Niles Rd
Suite 7
Saint Joseph, MI 49085-3268
Phone (269) 281-0408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P2980TNMDClinical Psychologist
2980TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axon Psychology Group, PC CurrentSince Oct 12, 2020 Accepting new patients
Intercare Community Health Network CurrentSince Oct 20, 2012 Accepting new patients
Intercare Community Health Network CurrentSince Oct 20, 2012 Accepting new patients
Psychiatric and Psychological Specialties Clinical PastSince May 14, 2023 Accepting new patients
Innovative Senior Care Home Health of Holland LLC PastSince Dec 6, 2020 Accepting new patients

Locations

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

2500 Niles Rd
Ste 5
Saint Joseph, MI 49085
Phone (269) 281-0408

2500 Niles Rd
Ste 7
Saint Joseph, MI 49085
Phone (269) 281-0407

Organizations & group practices 5

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1649356379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NILES RD STE 5",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853225",
            "telephone_number": "269-281-0408",
            "fax_number": "269-281-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NILES RD STE 5",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853225",
            "telephone_number": "269-281-0408",
            "fax_number": "269-281-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLYE",
        "first_name": "STEPHANIE",
        "middle_name": "MERKEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P2980",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016982",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MERKEY",
            "middle_name": "MEAGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.