MEDICARE: MICHAEL MAYO

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

General Provider Information

NPI Number	:	1932057346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MAYO

Provider Business Mailing Address
First Line	:	364 BRISBANE AVE
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-3428
Country	:	US
Telephone Number	:	614-256-4242
Fax Number	:	614-386-0386

Provider Business Practice Location Address
First Line	:	28 TANGLEWOOD DR
Second Line	:
City	:	DELAWARE
State	:	OH
Zip	:	43015-1238
Country	:	US
Telephone Number	:	937-869-4325
Fax Number	:	614-386-0386

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

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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Directions to “ MICHAEL MAYO ” Practice Location

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