Liza Chytilo Mermelstein, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1347 Issued in NM

Practice address

9426 Indian School Rd NE
Suite 1
Albuquerque, NM 87112-2886

Phone

(505) 345-6100

Fax

(505) 345-4531

NPI assigned

Jun 5, 2007

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 NM

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

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Third Wave Psychotherapy of New MexicoGroup PAC ID 3678064821, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Third Wave Psychotherapy of New Mexico

  • Adult Mental Health Clinic/Center
  • Albuquerque, NM
  • NPI 1407730609
  Medicare reassignment Care Compare group NPD
• Liza C Mermelstein PHD LLC

  • Clinical Psychologist
  • Albuquerque, NM
  • NPI 1710387105
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1679775076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9426 INDIAN SCHOOL RD NE",
            "address_2": "SUITE 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122886",
            "telephone_number": "505-345-6100",
            "fax_number": "505-345-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9426 INDIAN SCHOOL RD NE",
            "address_2": "SUITE 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122886",
            "telephone_number": "505-345-6100",
            "fax_number": "505-345-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERMELSTEIN",
        "first_name": "LIZA",
        "middle_name": "CHYTILO",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "1347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merion Haworth LCSW LLC
• Merit Consulting, LLC
• Merit Family Medicine
• Kate Vellenga Meriwether, M.D.
• Michelle Merlet, PMHNP
• Elaine Merola, M.S., CF-SLP
• Carol Lorraine Merovka, MD
• Michelle Merrett, PA-C
• Stephanie Merrett, SLP
• Kelley Merrick

• Clinical Psychologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.