Individual provider Active NPI

Rebecca Mae Nerison, PH.D.

  • Counseling Psychologist
  • Tacoma, WA
National Provider Identifier
1649418773
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
2213 Issued in WA
Practice address
9040A Fitzsimmons Dr
Internal Medicine Clinic - Mamc
Tacoma, WA 98431-1100
Phone
(253) 968-5154
Fax
(253) 968-5154
NPI assigned
Jan 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 2213 WA Primary

Addresses

Primary practice location

9040A Fitzsimmons Dr
Internal Medicine Clinic - Mamc
Tacoma, WA 98431-1100

Mailing address

9040A Fitzsimmons Dr
Internal Medicine Clinic - Mamc
Tacoma, WA 98431-1100
Phone (253) 968-5154

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

LicenseStateTypeSpecialty
2213WAMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1649418773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040A FITZSIMMONS DR",
            "address_2": "INTERNAL MEDICINE CLINIC - MAMC",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-5154",
            "fax_number": "253-968-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040A FITZSIMMONS DR",
            "address_2": "INTERNAL MEDICINE CLINIC - MAMC",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-5154",
            "fax_number": "253-968-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERISON",
        "first_name": "REBECCA",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-28",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "2213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.