Individual provider Active NPI

Billine Jourdan, PSYD

  • Clinical Psychologist
  • Riviera Beach, FL
National Provider Identifier
1124502125
Registry record updated Dec 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY10246 Issued in FL
Practice address
7305 N Military TRL
Riviera Beach, FL 33410-7417
Phone
(561) 422-8262
NPI assigned
Sep 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY10246 FL Primary

Addresses

Primary practice location

7305 N Military TRL
Riviera Beach, FL 33410-7417

Mailing address

7305 N Military TRL
Riviera Beach, FL 33410-7417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230620000071 FL Practitioner - Clinical Psychologist 7416315726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY10246FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthrough Therapeutics CurrentSince May 25, 2023 Accepting new patients
Breakthrough Therapeutics CurrentSince Nov 21, 2021 Accepting new patients

Locations

10570 S US Highway 1
Ste 300
Port St Lucie, FL 34952
Phone (561) 247-5550

7750 Okeechobee Blvd
Ste 41032
West Palm Beach, FL 33411
Phone (561) 247-5550

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609027200000",
    "number": "1124502125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7305 N MILITARY TRL",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334107417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 N MILITARY TRL",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334107417",
            "telephone_number": "561-422-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOURDAN",
        "first_name": "BILLINE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2020-12-27",
        "certification_date": "2020-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riviera Beach, FL

Sources for this page

Verify at the official NPI Registry.