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

Last updated

Jul 21, 2017By the provider in NPPES

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 PSYCHOLOGISTNPI 1750705836

Title

Owner

Phone

(239) 834-9333

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marek R Moldawsky Jr., M.ED., ED.S.

  • School Psychologist
  • Cape Coral, FL
  • NPI 1750705836
  Authorized official Same address or phone

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": []
}

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• 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.