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Individual

LISA SUNDVALL MERILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
221 N CAUSEWAY, SUITE B, NEW SMYRNA BEACH, FL 32169-5298
(386) 423-0442
(386) 423-0402
Mailing address
221 N CAUSEWAY, SUITE B, NEW SMYRNA BEACH, FL 32169-5298
(386) 423-0442
(386) 423-0402

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY 6889
FL
103T00000X
Psychologist
PY6889
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1416
DISABILITY DETERMINATIONS
FL
01
7280563
AETNA
FL
01
74094
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/09/2006
Last updated
09/11/2025
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