| Risa E. Newell, Ph.d., L.l.c. | |
|
11110 N Tatum Blvd Suite 103 Phoenix AZ 85028-1607 | |
| (602) 478-1477 | |
| (602) 443-0400 |
| Full Name | Risa E. Newell, Ph.d., L.l.c. |
|---|---|
| Speciality | Psychologist |
| Location | 11110 N Tatum Blvd, Phoenix, Arizona |
| Authorized Official Name and Position | Larisa Eubank Newell (PRESIDENT) |
| Authorized Official Contact | 6024781477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Risa E. Newell, Ph.d., L.l.c. 11110 N Tatum Blvd Suite 103 Phoenix AZ 85028-1607 Ph: (602) 478-1477 | Risa E. Newell, Ph.d., L.l.c. 11110 N Tatum Blvd Suite 103 Phoenix AZ 85028-1607 Ph: (602) 478-1477 |
| NPI Number | 1902093164 |
|---|---|
| Provider Enumeration Date | 10/01/2007 |
| Last Update Date | 10/25/2017 |
| Medicare PECOS PAC ID | 3072587922 |
|---|---|
| Medicare Enrollment ID | O20040825000775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902093164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3330 (Arizona) | Primary |
| Provider Name | Larisa Eubank Newell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801852991 PECOS PAC ID: 6608848593 Enrollment ID: I20040811000355 |
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