Dainery M. Fuentes, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY004076 Issued in FL

Practice address

464 W Pipkin Rd
Lakeland, FL 33813-2699

Phone

(863) 648-1812

NPI assigned

Apr 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Dainery M. Fuentes, PHD

  • Clinical Psychologist
  • Lakeland, FL
  • NPI 1063953644
  NPD (past) Authorized official

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616803200000",
    "number": "1104949452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5897 LAKE VICTORIA DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338134711",
            "telephone_number": "863-648-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 W PIPKIN RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132699",
            "telephone_number": "863-648-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "DAINERY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2021-03-27",
        "certification_date": "2021-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY004076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A Frye, MS, LCMHC
• FST Behavioral
• Doriangel Fuchs, MSW
• Nillymar Fuentes Villalona, BEHAVIOR TECHNICIAN
• Adriana C Fuentes-Arce
• Oriana Fuguet Machado
• Christopher Fuhrman, PA-C
• Coulton Nash Fuhrman
• Fulfilling Endeavors Incorporated
• Full Circle Counseling & Wellness, LLC

• Clinical Psychologist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2021; 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.