MEDICARE: RACHELE ALEXANDRA MERK PSYCHOLOGIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PY0865	NV
2	103TC0700X	Clinical Psychologist	PSY.0006867	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457834202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELE ALEXANDRA MERK PSYCHOLOGIST

Provider Business Mailing Address
First Line	:	421 US-6 AND 50
Second Line	:
City	:	FRUITA
State	:	CO
Zip	:	81521
Country	:	US
Telephone Number	:	702-573-5916
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 US-6 AND 50
Second Line	:
City	:	FRUITA
State	:	CO
Zip	:	81521
Country	:	US
Telephone Number	:	702-573-5916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2018
Last Update Date	:	06/10/2026

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