NPIMap

Organization Active NPI

CD Psychological Practice, PA

  • Psychologist
  • Fort Myers, FL
National Provider Identifier
1114348794
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
MH 10313 Issued in FL
Legal business name
CD PSYCHOLOGICAL PRACTICE, PA
Practice address
1937 Grace Ave Ste 100
Fort Myers, FL 33901-7119
Phone
(239) 340-5589
NPI assigned
Dec 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Authorized official

Name
Dr. Cynthia Davey, PH.D.NPI 1245640473
Title
Psychologist
Phone
(718) 268-6600

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MH 10313 FL
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X MH 10313 FL Primary

Addresses

Primary practice location

1937 Grace Ave Ste 100
Fort Myers, FL 33901-7119

Mailing address

118-35 Queens Blvd
Suite 1403
Forest Hills, NY 11375-7205
Phone (718) 268-6600

National Provider Directory

National Provider Directory

Locations

1937 Grace Ave
Ste 100
Fort Myers, FL 33901
Phone (239) 340-5589

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": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1114348794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118-35 QUEENS BLVD",
            "address_2": "SUITE 1403",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757205",
            "telephone_number": "718-268-6600",
            "fax_number": "718-268-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 GRACE AVE STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017119",
            "telephone_number": "239-340-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CD PSYCHOLOGICAL PRACTICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "DAVEY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "718-268-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 10313",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "MH 10313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.