Laurie Donaldson, PHD, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY9009 Issued in FL

Legal business name

LAURIE DONALDSON, PHD, LLC

Doing business as

Melbourne Integrative Psychology

Practice address

3270 Suntree Blvd
Suite 1135
Melbourne, FL 32940-7530

Phone

(412) 303-0157

NPI assigned

Oct 30, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Laurie M Donaldson, PHDNPI 1356369961

Title

President

Phone

(412) 303-0157

Specialties & licenses 1

Addresses

Other names 1

• Melbourne Integrative Psychology Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Laurie Marie Donaldson, PH.D.

  • Clinical Psychologist
  • Melbourne, FL
  • NPI 1356369961
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1477785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477785600000",
    "number": "1154873750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5954 NEWBURY CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401880",
            "telephone_number": "412-303-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 SUNTREE BLVD",
            "address_2": "SUITE 1135",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407530",
            "telephone_number": "412-303-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURIE DONALDSON, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-30",
        "last_updated": "2016-10-30",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-303-0157",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melbourne Integrative Psychology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychologist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2016; 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.