Active NPI
Melba Carole Arrick
- Clinical Psychologist
- Fort Walton Beach, FL
National Provider Identifier
1689690976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY4872
- Practice address
- 814 Shadow LN Ste B
Fort Walton Beach, FL 32547 - Phone
- (850) 862-3141
- Fax
- (850) 862-7732
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 | PY4872 | FL | Primary |
Addresses
Primary practice location
814 Shadow LN Ste B
Fort Walton Beach, FL 32547
Mailing address
814 Shadow LN Ste B
Fort Walton Beach, FL 32547-1282
Phone (850) 862-3141
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY4872 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529539200000",
"number": "1689690976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "814 SHADOW LN STE B",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325471282",
"telephone_number": "850-862-3141",
"fax_number": "850-862-7732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 SHADOW LN STE B",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "32547",
"telephone_number": "850-862-3141",
"fax_number": "850-862-7732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARRICK",
"first_name": "MELBA",
"middle_name": "CAROLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2018-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY4872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.