MARISSA L MASCORRO PSYD NPI 1063832343

NPI Information

  • NPI: 1063832343
  • Provider Name: MARISSA L MASCORRO, PSYD
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2120 S MCCLINTOCK DR
    SUITE 105
    TEMPE, AZ
    ZIP 85282
  • Phone: (480) 804-0326

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NPI Details

Marissa L Mascorro, PSYD is a clinical psychologist in Tempe, AZ with 2 years of experience. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. Marissa L Mascorro, PSYD NPI is 1063832343. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2120 S MCCLINTOCK DR
SUITE 105
TEMPE, AZ
ZIP 85282-692
Phone: (480) 804-0326
Fax: (480) 804-0083

The NPI 1063832343 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/24/2014 and was last updated on 5/13/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthLAC-13710ARIZONANo
2101YP2500XCounselorProfessionalLPC-17047ARIZONANo
3103TC0700XPsychologistClinicalPSY-005890ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1342848MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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