Active NPI
Staci Lorenzo Suits
- School Psychologist
- Green Cove Springs, FL
National Provider Identifier
1154976652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 1454
- Practice address
- 623 Oak St
Green Cove Springs, FL 32043-4313 - Phone
- (904) 531-9752
- NPI assigned
- Aug 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 1454 | FL | Primary |
Addresses
Primary practice location
623 Oak St
Green Cove Springs, FL 32043-4313
Mailing address
2313 Old Pine TRL
Orange Park, FL 32003-4916
Phone (904) 703-8498
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1454 | FL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564704000000",
"number": "1154976652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2313 OLD PINE TRL",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320034916",
"telephone_number": "904-703-8498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "623 OAK ST",
"city": "GREEN COVE SPRINGS",
"state": "FL",
"postal_code": "320434313",
"telephone_number": "904-531-9752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUITS",
"first_name": "STACI",
"middle_name": "LORENZO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-02",
"last_updated": "2019-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, School",
"state": "FL",
"license": "1454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Cove Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.