Bayside Neurotherapy, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BAYSIDE NEUROTHERAPY, LLC

Practice address

1022 W 23Rd St Ste 530
Panama City, FL 32405-3688

Phone

(850) 541-8520

Fax

(850) 541-9928

NPI assigned

Oct 8, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Cynthia Leigh Wilson, LPNPI 1255477584

Title

Licensed Clinical Psychologist

Phone

(850) 541-8520

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cynthia Leigh Wilson, PSYD

  • Clinical Psychologist
  • Panama City, FL
  • NPI 1255477584
  NPD Authorized official

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538956800000",
    "number": "1043785926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 W 23RD ST STE 530",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053688",
            "telephone_number": "850-541-8520",
            "fax_number": "850-541-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 W 23RD ST STE 530",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053688",
            "telephone_number": "850-541-8520",
            "fax_number": "850-541-9928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE NEUROTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "850-541-8520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bay Radiology Associates, PL
• Bay Radiology Womens Imaging Center LLC
• Bay Radiology Womens Imaging Center, LLC
• Bay Walk in Clinic, Inc
• Abdel-Azim Bayoumy, M.D.
• Bayside Psychiatry Inc
• Bayside Surgical Associates
• Joseph M Bazarte, O.D.
• Beach Midway Med Express
• Beach Primary Care LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Panama City, FL
• Providers in Panama City, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.