Active NPI
Sami Lyn Story Worssam, PHD, ARIZONA LICENSE
- Psychologist
- Sedona, AZ
National Provider Identifier
1982123881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4882
- Practice address
- 125 Rocky Rd
Sedona, AZ 86336-9132 - Phone
- (928) 567-8000
- Fax
- (928) 567-8063
- NPI assigned
- Sep 12, 2017
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4882 | AZ | Primary |
Addresses
Primary practice location
125 Rocky Rd
Sedona, AZ 86336-9132
Mailing address
125 Rocky Rd
Sedona, AZ 86336-9132
Phone (928) 567-8000
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4882 | AZ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1982123881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 ROCKY RD",
"city": "SEDONA",
"state": "AZ",
"postal_code": "863369132",
"telephone_number": "928-567-8000",
"fax_number": "928-567-8063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 ROCKY RD",
"city": "SEDONA",
"state": "AZ",
"postal_code": "863369132",
"telephone_number": "928-567-8000",
"fax_number": "928-567-8063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORSSAM",
"first_name": "SAMI LYN",
"middle_name": "STORY",
"credential": "PHD, ARIZONA LICENSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-12",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "4882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedona, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.