Individual provider Active NPI

Mary Kollias-Greber, PSY.D.

  • Clinical Psychologist
  • Aventura, FL
National Provider Identifier
1043436124
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6146 Issued in FL
Practice address
2875 NE 191St St Ste 500
Aventura, FL 33180-2832
Phone
(954) 963-5858
NPI assigned
Apr 18, 2007
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY6146 FL Primary

Addresses

Primary practice location

2875 NE 191St St Ste 500
Aventura, FL 33180-2832

Mailing address

PO Box 800644
Miami, FL 33280-0644
Phone (954) 963-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110623000754 FL Practitioner - Clinical Psychologist 4688569916 Practice locations: Aventura, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Aventura, FL 33160
Phone (954) 963-5858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY6146FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1043436124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800644",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332800644",
            "telephone_number": "954-963-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 NE 191ST ST STE 500",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331802832",
            "telephone_number": "954-963-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLIAS-GREBER",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.