Southwest Psychological Services, LLC

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

1290 Issued in FL

Legal business name

SOUTHWEST PSYCHOLOGICAL SERVICES, LLC

Practice address

4706 Chiquita Blvd S Ste 200
Cape Coral, FL 33914-6324

Phone

(239) 834-9333

NPI assigned

Jul 21, 2017

Organization subpart

No

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

Authorized official

Name

Marek R Moldawsky Jr., SCHOOL PSYCHOLOGIST

Title

Owner

Phone

(239) 834-9333

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500595200000",
    "number": "1114440112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4706 CHIQUITA BLVD S STE 200",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339146324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4706 CHIQUITA BLVD S STE 200",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339146324",
            "telephone_number": "239-834-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-21",
        "last_updated": "2017-07-21",
        "status": "A",
        "authorized_official_last_name": "MOLDAWSKY",
        "authorized_official_first_name": "MAREK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-834-9333",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "SCHOOL PSYCHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "1290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Florida Dental Group PA
• Southwest Florida Eye Care, L.L.C.
• Southwest Florida Sports Counseling LLC
• Southwest Internal Medicine P a
• Southwest Medical Equipment & Supplies Incorporated
• Southwest Spine and Sport, Inc.
• Amelda W. Span, M.S. EDUCATION
• Patricia A Spangaro, P.T.
• Speakeasy Services Inc
• Specialists in Urology, P.a.

• School Psychologist in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• School Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2017; 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.