Boca Raton Psychology Group PA

Primary specialty

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

Legal business name

BOCA RATON PSYCHOLOGY GROUP PA

Practice address

950 Peninsula Corporate Circle
Suite 3000
Boca Raton,, FL 33487-1387

Phone

(561) 999-8881

Fax

(561) 999-8884

NPI assigned

Apr 15, 2024

Organization subpart

No

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

Authorized official

Name

Maxie Harris III, PHDNPI 1346406840

Title

President

Phone

(954) 336-3807

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Maxie Harris, PH.D.

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1346406840
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1104670256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 PENINSULA CORPORATE CIR STE 3000",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334871387",
            "telephone_number": "561-999-8881",
            "fax_number": "561-999-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 PENINSULA CORPORATE CIRCLE",
            "address_2": "SUITE 3000",
            "city": "BOCA RATON,",
            "state": "FL",
            "postal_code": "334871387",
            "telephone_number": "561-999-8881",
            "fax_number": "561-999-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOCA RATON PSYCHOLOGY GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MAXIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-336-3807",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PHD"
    },
    "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": []
}

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• Boca Raton Regional Hospital, Inc.
• Boca Raton Regional Hospital, Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Boca Raton,, FL
• Providers in Boca Raton,, 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 Jun 10, 2024; 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.