Individual provider Active NPI

Harald Wolfgang Lettner, PHD

  • Clinical Neuropsychologist
  • Naples, FL
National Provider Identifier
1063523678
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY4878 Issued in FL
Practice address
501 Goodlette Rd N
Ste C 104
Naples, FL 34102-5661
Phone
(239) 434-6111
Fax
(239) 649-0472
NPI assigned
Aug 31, 2006
Last updated
Feb 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY4878 FL Primary
Clinical Psychologist 103TC0700X PY4878 FL

Addresses

Primary practice location

501 Goodlette Rd N
Ste C 104
Naples, FL 34102-5661

Mailing address

501 Goodlette Rd N
Ste C 104
Naples, FL 34102-5661
Phone (239) 434-6111

Other identifiers 2

IdentifierTypeStateIssuer
59545OtherFLBLUE CROSS BLUE SHIELD
PY4878OtherFLLICENSE NUMBER

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)
Enrolled
Credentials
Doctor of Philosophy

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1063523678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOODLETTE RD N",
            "address_2": "STE C 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025661",
            "telephone_number": "239-434-6111",
            "fax_number": "239-649-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOODLETTE RD N",
            "address_2": "STE C 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025661",
            "telephone_number": "239-434-6111",
            "fax_number": "239-649-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTNER",
        "first_name": "HARALD",
        "middle_name": "WOLFGANG",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY4878",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4878",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "59545",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PY4878",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.