Individual provider Active NPI

Melanie S Anderson, PSYD

  • Addiction (Substance Use Disorder) Psychologist
  • Scottsdale, AZ
National Provider Identifier
1710398995
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
License
4494 Issued in AZ
Practice address
33755 N Scottsdale Rd
Suite J-105
Scottsdale, AZ 85266-1567
Phone
(480) 595-1555
Fax
(866) 307-0007
NPI assigned
May 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 4494 AZ Primary
Adult Development & Aging Psychologist 103TA0700X 4494 AZ
Cognitive & Behavioral Psychologist 103TB0200X 4494 AZ
Clinical Psychologist 103TC0700X 4494 AZ
Clinical Child & Adolescent Psychologist 103TC2200X 4494 AZ
Family Psychologist 103TF0000X 4494 AZ
Forensic Psychologist 103TF0200X 4494 AZ
Health Psychologist 103TH0004X 4494 AZ
Group Psychotherapy Psychologist 103TP2701X 4494 AZ
Rehabilitation Psychologist 103TR0400X 4494 AZ

Addresses

Primary practice location

33755 N Scottsdale Rd
Suite J-105
Scottsdale, AZ 85266-1567

Mailing address

33755 N Scottsdale Rd
Suite J-105
Scottsdale, AZ 85266-1567
Phone (480) 595-1555

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

State licenses

LicenseStateTypeSpecialty
4494AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Melanie S Anderson PSYD PLLC Psychologist PastSince May 12, 2014 Accepting new patients
Black Mountain Neuropsychology, PLLC Psychologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1710398995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33755 N SCOTTSDALE RD",
            "address_2": "SUITE J-105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852661567",
            "telephone_number": "480-595-1555",
            "fax_number": "866-307-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33755 N SCOTTSDALE RD",
            "address_2": "SUITE J-105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852661567",
            "telephone_number": "480-595-1555",
            "fax_number": "866-307-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MELANIE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-09",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "4494",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "AZ",
            "license": "4494",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AZ",
            "license": "4494",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4494",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "4494",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "AZ",
            "license": "4494",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "AZ",
            "license": "4494",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "AZ",
            "license": "4494",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "AZ",
            "license": "4494",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "AZ",
            "license": "4494",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.