NPIMap

Organization Active NPI

Marden Petrie, PSYD, PLLC

  • Clinical Psychologist
  • Tucson, AZ
National Provider Identifier
1831551696
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4231 Issued in AZ
Legal business name
MARDEN PETRIE, PSYD, PLLC
Practice address
6592 N Oracle Rd
Tucson, AZ 85704-5640
Phone
(520) 488-4602
Fax
(888) 429-6085
NPI assigned
Mar 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Authorized official

Name
Dr. Marden Petrie, PSYDNPI 1760663066
Title
Clinical Psychologist
Phone
(520) 488-4602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 4231 AZ Primary

Addresses

Primary practice location

6592 N Oracle Rd
Tucson, AZ 85704-5640

Mailing address

11114 N Falling Rain Rd
Oro Valley, AZ 85737-7321
Phone (520) 488-4602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160331002156 AZ Part B Supplier - Clinic/Group Practice 0042517302 Receives reassigned benefits from 1 practitioner
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

6885 N Oracle Rd
Tucson, AZ 85704

6592 N Oracle Rd
Tucson, AZ 85704
Phone (520) 485-8424

6885 N Oracle Rd
Ste C
Tucson, AZ 85704
Phone (520) 488-4602

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1831551696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11114 N FALLING RAIN RD",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857377321",
            "telephone_number": "520-488-4602",
            "fax_number": "888-429-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6592 N ORACLE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045640",
            "telephone_number": "520-488-4602",
            "fax_number": "888-429-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARDEN PETRIE, PSYD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "PETRIE",
        "authorized_official_first_name": "MARDEN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "520-488-4602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.