NPIMap

Organization Active NPI

Psychological Management Group, PA

  • Counseling Psychologist
  • Tampa, FL
National Provider Identifier
1144384264
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PY4542 Issued in FL
Legal business name
PSYCHOLOGICAL MANAGEMENT GROUP, PA
Practice address
15436 N Florida Ave Ste 102
Tampa, FL 33613-1225
Phone
(813) 963-1016
Fax
(813) 961-6591
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Authorized official

Name
Dr. Robert C. Wright, PH.D.NPI 1114046679
Title
Director
Phone
(813) 963-1016

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X PY4542 FL Primary

Addresses

Primary practice location

15436 N Florida Ave Ste 102
Tampa, FL 33613-1225

Mailing address

15436 N Florida Ave Ste 102
Tampa, FL 33613-1225
Phone (813) 963-1016

Other identifiers 1

IdentifierTypeStateIssuer
94978OtherFLBC BS

National Provider Directory

National Provider Directory

Locations

15436 N Florida Ave
Ste 102
Tampa, FL 33613
Phone (813) 960-5660

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1144384264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15436 N FLORIDA AVE STE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131225",
            "telephone_number": "813-963-1016",
            "fax_number": "813-961-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15436 N FLORIDA AVE STE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131225",
            "telephone_number": "813-963-1016",
            "fax_number": "813-961-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL MANAGEMENT GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "813-963-1016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY4542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "94978",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

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