Active NPI
Ivy Chong, PHD
- Psychologist
- Melbourne, FL
National Provider Identifier
1033306733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 8214
- Practice address
- 150 W University Blvd
Scott Center for Autism Treatment
Melbourne, FL 32901-6982 - Phone
- (321) 674-8615
- Fax
- (321) 674-8411
- NPI assigned
- Sep 27, 2007
- Last updated
- Jul 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 8214 | FL | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 6301012869 | MI | |
| Behavior Analyst | 103K00000X | 1-04-1585 | FL |
Addresses
Primary practice location
150 W University Blvd
Scott Center for Autism Treatment
Melbourne, FL 32901-6982
Mailing address
150 W University Blvd
Scott Center for Autism Treatment
Melbourne, FL 32901-6982
Phone (321) 674-8615
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301012869 | MI | MD | Clinical Child & Adolescent Psychologist |
| 8214 | FL | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310342400000",
"number": "1033306733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 W UNIVERSITY BLVD",
"address_2": "SCOTT CENTER FOR AUTISM TREATMENT",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329016982",
"telephone_number": "321-674-8615",
"fax_number": "321-674-8411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 W UNIVERSITY BLVD",
"address_2": "SCOTT CENTER FOR AUTISM TREATMENT",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329016982",
"telephone_number": "321-674-8615",
"fax_number": "321-674-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHONG",
"first_name": "IVY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-27",
"last_updated": "2011-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "8214",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MI",
"license": "6301012869",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-04-1585",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
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- Chiropractic Specialist of Brevard, Inc. (Suntree Chiropractic)
- Chiropractuc Envy Health & Wellness
- Charles H. Chodorow, D.O.
- Kathleen Chodur
- Sarah Choo-Yick, MD
- Rahul R Chopra, M.D.
- Elizabeth Wyman Chrencik, MS, RD, LD/N
- Milad Chrieki, M.D.
- Christie Chiropractic Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.