Active NPI
Merrilee Anderson, PH.D.
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1750465605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2-4846
- Practice address
- 12700 Park Central Dr
Suite 1470
Dallas, TX 75251-1500 - Phone
- (469) 484-2992
- NPI assigned
- Oct 25, 2006
- Last updated
- Feb 10, 2014
- 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 | 2-4846 | TX | Primary |
Addresses
Primary practice location
12700 Park Central Dr
Suite 1470
Dallas, TX 75251-1500
Mailing address
12700 Park Central Dr
Suite 1470
Dallas, TX 75251-1500
Phone (469) 484-2992
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 |
|---|---|---|---|
| 2-4846 | TX | MD | Clinical Psychologist |
| 24846 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391990400000",
"number": "1750465605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12700 PARK CENTRAL DR",
"address_2": "SUITE 1470",
"city": "DALLAS",
"state": "TX",
"postal_code": "752511500",
"telephone_number": "469-484-2992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12700 PARK CENTRAL DR",
"address_2": "SUITE 1470",
"city": "DALLAS",
"state": "TX",
"postal_code": "752511500",
"telephone_number": "469-484-2992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MERRILEE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2014-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "2-4846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.