MICAH MAMMEN PSYCHOLOGIST
NPI 1316473994
Psychologist - Clinical in Chandler, AZ

Q: What is Micah Mammen's NPI number?

The NPI number for Micah Mammen is 1316473994. It was assigned to this individual provider in the NPPES registry on May 3, 2017.

Q: What is Micah Mammen's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Micah Mammen was last updated on December 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 03, 2017PECOS Enrolled

1600 W CHANDLER BLVD STE 110, CHANDLER, AZ 85224(480) 524-0990 Get Directions Write a Review

NPPES record last updated: December 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 8, 2021, Apr 23, 2019 (2 updates tracked since 2019).

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About Micah Mammen Psychologist NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICAH MAMMEN PSYCHOLOGIST (NPI 1316473994) is an individual clinical provider in Chandler, Arizona, licensed in Arizona (PSY-005068) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316473994

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameMICAH MAMMENCredential: PSYCHOLOGIST

Location Address1600 W CHANDLER BLVD STE 110Chandler, AZ 85224-6100

Mailing Address1600 W Chandler Blvd Ste 110Chandler, AZ 85224-6100 · (480) 524-0990

Phone(480) 524-0990

Sole ProprietorNo

Enumeration DateMay 3, 2017

Last NPPES UpdateDecember 8, 20212 updates tracked since enumeration

NPPES CertifiedDecember 7, 2021

✔ NPI 1316473994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in AZ · PSY-005068

Definition

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1600 W CHANDLER BLVD STE 110, Chandler, AZ 85224

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Micah Mammen Psychologist is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85224 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$168.60 typical visit price

range $55.44 – $168.60

Typical copayment $42.15 (range $13.86 – $42.15)

Most-billed visit code 99205

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHERISH DEOLIVEIRA PSY.D.

Psychologist (Clinical)