Provider Demographics
NPI:1558586461
Name:MERRIFIELD, LISA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:L
Last Name:MERRIFIELD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8011 CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3533
Mailing Address - Country:US
Mailing Address - Phone:402-345-2374
Mailing Address - Fax:402-345-2376
Practice Address - Street 1:8011 CHICAGO ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3533
Practice Address - Country:US
Practice Address - Phone:402-345-2374
Practice Address - Fax:402-345-2376
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2195103TC0700X
NE738103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE084318OtherBLUE CROSS BLUE SHIELD
NE237385OtherMIDLAND'S CHOICE