Mitchell Kroungold, PH.D.
Individual provider Active NPI Psychologist · Belleair, FL
NPI 1154403228 · NPPES record last updated Oct 7, 2010
Key facts
- NPI
- 1154403228
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PY2366 (FL)
- Practice address
- 401 Corbett St
Suite 300
Belleair, FL 33756-7309 - Phone
- (727) 442-6007
- Fax
- (727) 441-3981
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY2366 | FL | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY2366 | FL | Yes |
Addresses
Primary practice location
401 Corbett St
Suite 300
Belleair, FL 33756-7309
Mailing address
14236 Mark Dr
Largo, FL 33774-5110
Phone (727) 596-9923
Other providers in Belleair, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.