Individual provider Active NPI

Cheryl Jane Kasprzak, PSY.D.

  • Clinical Psychologist
  • Naples, FL
National Provider Identifier
1134100381
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6194 Issued in FL
Practice address
3227 Horseshoe Dr S
Suite 101
Naples, FL 34104-6114
Phone
(239) 262-4543
Fax
(239) 949-9555
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY6104 FL
Cognitive & Behavioral Psychologist 103TB0200X PY6194 FL
Clinical Psychologist 103TC0700X PY6194 FL Primary
Clinical Child & Adolescent Psychologist 103TC2200X PY6194 FL
Psychologist 103T00000X PY6194 FL

Addresses

Primary practice location

3227 Horseshoe Dr S
Suite 101
Naples, FL 34104-6114

Mailing address

PO Box 990461
Naples, FL 34116-6065
Phone (239) 262-4543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY6104FLMDPsychologist
PY6194FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Behavioral Healthcare PA Psychologist Past Accepting new patients

Organizations & group practices 1

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1134100381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990461",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341166065",
            "telephone_number": "239-262-4543",
            "fax_number": "239-949-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227 HORSESHOE DR S",
            "address_2": "SUITE 101",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341046114",
            "telephone_number": "239-262-4543",
            "fax_number": "239-949-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASPRZAK",
        "first_name": "CHERYL",
        "middle_name": "JANE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6104",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY6194",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6194",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY6194",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6194",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; 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.