Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Micah Mammen, PSYCHOLOGIST

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1316473994

Micah Mammen, PSYCHOLOGIST is a Student in an Organized Health Care Education/Training Program in Chandler, Arizona. Licensed in Arizona. Registered with an NPI since 2017.

Licensed in
AZ
In the registry since
2017
Specialties on file
2

Practice location Address checks out

1600 W Chandler Blvd Ste 110
Chandler, AZ 85224-6100
Phone: (480) 524-0990
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY-005068 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1316473994
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYCHOLOGIST
Sole proprietorNo
NPI enumeratedMay 3, 2017
Last updated in NPPESDecember 8, 2021
Certification dateDecember 7, 2021

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