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MELISSA EDWARDS PETERSEN PHD NPI 1144860917


NPI Information

NPI: 1144860917
Provider Name: MELISSA EDWARDS PETERSEN, PHD
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
855 MONTGOMERY ST
FORT WORTH, TX
ZIP 76107
Phone: (817) 735-2200
Get Directions

Melissa Edwards Petersen, PHD is a clinical neuropsychologist in Fort Worth, TX. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Melissa Edwards Petersen, PHD NPI is 1144860917. 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:

855 MONTGOMERY ST
FORT WORTH, TX
ZIP 76107-553
Phone: (817) 735-2200

The NPI 1144860917 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 1/9/2020 and was last updated on 10/15/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103G00000XClinical Neuropsychologist36939TEXASYes
2103TC0700XPsychologistClinical36939TEXASNo

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.