Individual provider Active NPI

Melissa J Lafferty, PHD

  • Clinical Psychologist
  • Lincoln, NE
National Provider Identifier
1881010668
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1097 Issued in NE
Practice address
4545 S 86TH St
Lincoln, NE 68526-9262
Phone
(402) 483-6990
Fax
(402) 483-7045
NPI assigned
Mar 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1097 NE Primary
Psychologist 103T00000X 167 NE

Addresses

Primary practice location

4545 S 86TH St
Lincoln, NE 68526-9262

Mailing address

4545 S 86TH St
Lincoln, NE 68526-9262
Phone (402) 483-6990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014000578 NE Practitioner - Clinical Psychologist 1557737665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Silver Sun Mental HealthGroup PAC ID 4082885793, 9 clinicians

Practice addresses (Care Compare)

4545 S 86TH St
Lincoln, NE 68526-9262
Phone (402) 483-6990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
167NEMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Sun Mental Health CurrentSince Oct 10, 2022 Accepting new patients

Locations

110 N 9th St
Beatrice, NE 68310
Phone (402) 483-6990

4545 S 86th St
Lincoln, NE 68526
Phone (402) 483-6990

Organizations & group practices 1

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": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1881010668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 S 86TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269262",
            "telephone_number": "402-483-6990",
            "fax_number": "402-483-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 S 86TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269262",
            "telephone_number": "402-483-6990",
            "fax_number": "402-483-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFFERTY",
        "first_name": "MELISSA",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "1097",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.