Head Space Therapy Center

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

HEAD SPACE THERAPY CENTER

Practice address

110 Lily Flagg Rd SE
Huntsville, AL 35802

Phone

(256) 501-1115

NPI assigned

Mar 29, 2024

Organization subpart

Yes

Parent organization

HEAD SPACE THERAPY CENTERAs reported in NPPES

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

Authorized official

Name

Judy Carol Park, PSYDNPI 1497896567

Title

Psychologist

Phone

(256) 501-1115

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Part of

Head Space Therapy Center

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judy C Park, PSYD

  • Clinical Psychologist
  • Huntsville, AL
  • NPI 1497896567
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1144071986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 CASTLE DOWN DR SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021293",
            "telephone_number": "256-426-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LILY FLAGG RD SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35802",
            "telephone_number": "256-501-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAD SPACE THERAPY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEAD SPACE THERAPY CENTER",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "256-501-1115",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara W Hayles, PHARMD
• Anu Haynes, RN
• Kimberly Dawn Hazel, ALC
• Valannda Latice Hazzard, LPC
• HC Healthcare, LLC
• Healing & Feeling Collective LLC
• Healing Collective, LLC
• Healing Hearts With Love Homecare LLC
• Healing Horizons Counseling LLC
• Heals Inc

• Clinical Psychologist in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Clinical Psychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.