Provider Demographics
NPI:1336349513
Name:GERALD S. MAYER, PH.D., P.C.
Entity Type:Organization
Organization Name:GERALD S. MAYER, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-943-0040
Mailing Address - Street 1:7227 N 16TH ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5251
Mailing Address - Country:US
Mailing Address - Phone:602-943-0040
Mailing Address - Fax:602-043-8049
Practice Address - Street 1:7227 N 16TH ST
Practice Address - Street 2:SUITE 222
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5251
Practice Address - Country:US
Practice Address - Phone:602-943-0040
Practice Address - Fax:602-043-8049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1204103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty