Individual provider Active NPI

Lisa Sundvall Merilson, PSY.D.

  • Clinical Neuropsychologist
  • New Smyrna Beach, FL
National Provider Identifier
1932140175
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY 6889 Issued in FL
Practice address
221 N Causeway
Suite B
New Smyrna Beach, FL 32169-5298
Phone
(386) 423-0442
Fax
(386) 423-0402
NPI assigned
Jun 9, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY 6889 FL Primary
Psychologist 103T00000X PY6889 FL

Addresses

Primary practice location

221 N Causeway
Suite B
New Smyrna Beach, FL 32169-5298

Mailing address

221 N Causeway
Suite B
New Smyrna Beach, FL 32169-5298
Phone (386) 423-0442

Other identifiers 3

IdentifierTypeStateIssuer
74094OtherFLBLUE CROSS BLUE SHIELD
7280563OtherFLAETNA
1416OtherFLDISABILITY DETERMINATIONS

Other names 1

  • Lisa M. Sundvall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060908000044 FL Practitioner - Clinical Psychologist 3678556206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Volusia Neuropsychology and Behavioral Health IncGroup PAC ID 0244213874, 4 clinicians

Practice addresses (Care Compare)

221 N Causeway B
New Smyrna Beach, FL 32169-5200
Phone (386) 423-0442

512 Canal St
New Smyrna Beach, FL 32168-7012
Phone (386) 423-0442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 6889FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Volusia Neuropsychology & Behavioral Health Inc Clinical Neuropsychologist CurrentSince Sep 30, 2003 Accepting new patients

Locations

221 N Causeway
#B
New Smyrna Beach, FL 32169
Phone (386) 423-0442

221 N Causeway
Ste B
New Smyrna Beach, FL 32169
Phone (386) 423-0442

512 Canal St
New Smyrna Beach, FL 32168
Phone (386) 423-0442

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1932140175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 N CAUSEWAY",
            "address_2": "SUITE B",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321695298",
            "telephone_number": "386-423-0442",
            "fax_number": "386-423-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 N CAUSEWAY",
            "address_2": "SUITE B",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321695298",
            "telephone_number": "386-423-0442",
            "fax_number": "386-423-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERILSON",
        "first_name": "LISA",
        "middle_name": "SUNDVALL",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY 6889",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6889",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "74094",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7280563",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DISABILITY DETERMINATIONS",
            "identifier": "1416",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SUNDVALL",
            "middle_name": "M.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.