Organization Active NPI

Baillio Psychological Services, PA

  • Counseling Psychologist
  • Saint Petersburg, FL
National Provider Identifier
1053798702
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PY8287 Issued in FL
Legal business name
BAILLIO PSYCHOLOGICAL SERVICES, PA
Practice address
735 Arlington Ave N
Suite 205
Saint Petersburg, FL 33701-3652
Phone
(813) 294-0577
NPI assigned
May 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Authorized official

Name
Dr. Jill N Baillio, PHDNPI 1255649208
Title
Owner
Phone
(813) 294-0577

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X PY8287 FL Primary

Addresses

Primary practice location

735 Arlington Ave N
Suite 205
Saint Petersburg, FL 33701-3652

Mailing address

4081 Beach Dr SE
Saint Petersburg, FL 33705-4125
Phone (813) 294-0577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150727001575 FL Part B Supplier - Clinic/Group Practice 9537473145 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Petersburg, FL
O20191112000851 AZ Part B Supplier - Clinic/Group Practice 9537473145 Receives reassigned benefits from 1 practitioner
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

1900 Dr Martin Luther King Jr St N
St Petersburg, FL 33704
Phone (813) 294-0577

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1053798702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4081 BEACH DR SE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337054125",
            "telephone_number": "813-294-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 ARLINGTON AVE N",
            "address_2": "SUITE 205",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013652",
            "telephone_number": "813-294-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAILLIO PSYCHOLOGICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "BAILLIO",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-294-0577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY8287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.