Active NPI
Lisa Anne Merconchini, PSY.D.
- Clinical Psychologist
- Ft Lauderdale, FL
National Provider Identifier
1710128574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 7862
- Practice address
- 110 E Broward Blvd
Suite 1700
Ft Lauderdale, FL 33301-3503 - Phone
- (954) 415-5343
- Fax
- (954) 315-0263
- NPI assigned
- Mar 9, 2009
- 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 | PY 7862 | FL | Primary |
Addresses
Primary practice location
110 E Broward Blvd
Suite 1700
Ft Lauderdale, FL 33301-3503
Mailing address
110 E Broward Blvd
Suite 1700
Ft Lauderdale, FL 33301-3503
Phone (954) 415-5343
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 7862 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266710400000",
"number": "1710128574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 E BROWARD BLVD",
"address_2": "SUITE 1700",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333013503",
"telephone_number": "954-415-5343",
"fax_number": "954-315-0263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E BROWARD BLVD",
"address_2": "SUITE 1700",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333013503",
"telephone_number": "954-415-5343",
"fax_number": "954-315-0263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCONCHINI",
"first_name": "LISA",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-09",
"last_updated": "2010-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY 7862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.