Basic Information
| Provider Information | |||||||||
| NPI: | 1194810499 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAYFIELD | ||||||||
| FirstName: | ARISTA | ||||||||
| MiddleName: | DIANNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 7TH AVENUE SOUTH | ||||||||
| Address2: | SUITE 500 ACC BUILDING | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059399193 | ||||||||
| FaxNumber: | 2059399949 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 7TH AVENUE SOUTH | ||||||||
| Address2: | SUITE 500 ACC BUILDING | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059399193 | ||||||||
| FaxNumber: | 2059399949 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 04/16/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 1146 | AL | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103T00000X | 1146 | AL | N | Behavioral Health & Social Service Providers | Psychologist |
ID Information
| ID | Type | State | Issuer | Description | 515-03115 | 01 | AL | FEDERAL BC | OTHER | 890007520 | 05 | AL | MEDICAID | 1194810499 | 01 | AL | TRICARE SOUTH | OTHER | 101622 | 05 | AL | MEDICAID | 51008157 | 01 | AL | ALL KIDS | OTHER | 515-01369 | 01 | AL | BCBS | OTHER | 515-01368 | 01 | AL | BCBS | OTHER |