NPIMap

Organization Active NPI

Peace River Psychology Center PA

  • Psychologist
  • Punta Gorda, FL
National Provider Identifier
1003049172
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY6197 Issued in FL
Legal business name
PEACE RIVER PSYCHOLOGY CENTER PA
Practice address
425 Cross St
Ste 111
Punta Gorda, FL 33950-4877
Phone
(941) 505-6162
Fax
(941) 505-8604
NPI assigned
Aug 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Karin Galliano, PHD
Title
Owner
Phone
(941) 505-6162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY6197 FL Primary

Addresses

Primary practice location

425 Cross St
Ste 111
Punta Gorda, FL 33950-4877

Mailing address

425 Cross St
Ste 111
Punta Gorda, FL 33950-4877
Phone (941) 505-6162

National Provider Directory

National Provider Directory

Locations

425 Cross St
Ste 111
Punta Gorda, FL 33950
Phone (941) 255-5489

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1003049172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 CROSS ST",
            "address_2": "STE 111",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339504877",
            "telephone_number": "941-505-6162",
            "fax_number": "941-505-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 CROSS ST",
            "address_2": "STE 111",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339504877",
            "telephone_number": "941-505-6162",
            "fax_number": "941-505-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE RIVER PSYCHOLOGY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-24",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "GALLIANO",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-505-6162",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.