Provider Demographics
NPI:1194810499
Name:RAYFIELD, ARISTA DIANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:ARISTA
Middle Name:DIANNE
Last Name:RAYFIELD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 7TH AVENUE SOUTH
Mailing Address - Street 2:SUITE 500 ACC BUILDING
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233
Mailing Address - Country:US
Mailing Address - Phone:205-939-9193
Mailing Address - Fax:205-939-9949
Practice Address - Street 1:1600 7TH AVENUE SOUTH
Practice Address - Street 2:SUITE 500 ACC BUILDING
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-939-9193
Practice Address - Fax:205-939-9949
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1146103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-03115OtherFEDERAL BC
AL890007520Medicaid
AL1194810499OtherTRICARE SOUTH
AL101622Medicaid
AL51008157OtherALL KIDS
AL515-01369OtherBCBS
AL515-01368OtherBCBS
ALS77662Medicare UPIN