DR. MICHAEL JACK MELLOTT ED.D.
NPI 1760546147
Psychologist - School in Flagstaff, AZ

Active since December 20, 2006
3509 S DYLAN ST, FLAGSTAFF, AZ 86001(928) 774-4658(928) 774-4658 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Michael Jack Mellott Ed.d. NPPES

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

DR. MICHAEL JACK MELLOTT ED.D. (NPI 1760546147) is an individual school provider in Flagstaff, Arizona, licensed in Arizona (3598) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1760546147
Entity TypeIndividualMale
Primary Taxonomy103TS0200X
Provider Legal NameDR. MICHAEL JACK MELLOTTCredential: ED.D.
Location Address3509 S DYLAN STFlagstaff, AZ 86001-9137
Mailing Address3509 S Dylan StFlagstaff, AZ 86001-9137 · (928) 774-4658 · Fax (928) 774-4658
Fax(928) 774-4658
Sole ProprietorYes
Enumeration DateDecember 20, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1760546147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · SchoolBehavioral Health & Social Service Providers
Taxonomy Code103TS0200X
License Licensed in AZ · 3598
Definition

A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development

3509 S DYLAN ST, Flagstaff, AZ 86001

Other Identifiers 1

Other913039AZ · Ahcccs Provider Number

Other Providers at the Same Location NPPES

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

Psychologist
3509 S DYLAN ST
FLAGSTAFF, AZ 86001

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1760546147, enumerated as an "individual" on December 20, 2006.

The provider is located at 3509 S DYLAN ST FLAGSTAFF, AZ 86001 and the phone number is (928) 774-4658.

Psychologist with taxonomy code 103TS0200X and a focus in School.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.