Liza C Mermelstein PHD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1347 Issued in NM

Legal business name

LIZA C MERMELSTEIN PHD LLC

Practice address

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

Phone

(505) 345-6100

Fax

(505) 345-4531

NPI assigned

Sep 4, 2014

Last updated

Sep 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Liza Chytilo Mermelstein, PHDNPI 1679775076

Title

Managing Member

Phone

(607) 768-9640

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Liza Chytilo Mermelstein, PHD

  • Clinical Psychologist
  • Albuquerque, NM
  • NPI 1679775076
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1710387105",
    "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": {
        "organization_name": "LIZA C MERMELSTEIN PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "MERMELSTEIN",
        "authorized_official_first_name": "LIZA",
        "authorized_official_middle_name": "CHYTILO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "607-768-9640",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "1347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Living on Purpose, LLC
• Living on Purpose, LLC
• Marsden Patrick Anthony Livingston, DO
• Parker Livingston, DC
• Sabrina Livingston, DC
• Lee Ann Llamas, SW
• Irasema Llewellyn, FNP-BC
• Bianca J Lloyd, B.A.
• Celia Lloyd, ATC/L
• Jessica Lloyd, BCBA

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.