Organization Active NPI

Ashley Fogarty Lass, Psy.D.,P.a.

  • Clinical Psychologist
  • Tampa, FL
National Provider Identifier
1093753147
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7188 Issued in FL
Legal business name
ASHLEY FOGARTY LASS, PSY.D.,P.A.
Practice address
3616 W Roland St
Tampa, FL 33609-2832
Phone
(813) 789-3709
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ashley Fogarty Lass, PSY.D.NPI 1841241569
Title
Licensed Psychologist
Phone
(813) 789-3709

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY7188 FL Primary

Addresses

Primary practice location

3616 W Roland St
Tampa, FL 33609-2832

Mailing address

3616 W Roland St
Tampa, FL 33609-2832
Phone (813) 789-3709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070116000290 FL Part B Supplier - Clinic/Group Practice 3678574787 Receives reassigned benefits from 1 practitioner
Practice locations: Valrico, FL

National Provider Directory

National Provider Directory

Locations

730 S Sterling Ave
Ste 108
Tampa, FL 33609
Phone (813) 789-3709

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": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093753147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 W ROLAND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092832",
            "telephone_number": "813-789-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3616 W ROLAND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092832",
            "telephone_number": "813-789-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY FOGARTY LASS, PSY.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LASS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "FOGARTY",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "813-789-3709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.