Individual provider Active NPI

Davina Hardin, PSYD

  • Counseling Psychologist
  • West Melbourne, FL
National Provider Identifier
1174823850
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
2000 Commerce Dr
West Melbourne, FL 32904-2335
Phone
(321) 722-5200
NPI assigned
Oct 27, 2010
Last updated
Oct 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X NU Primary

Addresses

Primary practice location

2000 Commerce Dr
West Melbourne, FL 32904-2335

Mailing address

2000 Commerce Dr
West Melbourne, FL 32904-2335
Phone (321) 722-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121231000167 FL Practitioner - Clinical Psychologist 4688827512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Circles of Care IncGroup PAC ID 8729069380, 26 clinicians

Practice addresses (Care Compare)

2020 Commerce Dr
West Melbourne, FL 32904-2335
Phone (321) 952-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Circles of Care, Inc. CurrentSince Dec 14, 2012 Accepting new patients
Circles of Care, Inc. CurrentSince Dec 14, 2012 Accepting new patients

Locations

400 Sheridan Rd
Melbourne, FL 32901
Phone (321) 722-5273

2000 Commerce Dr
West Melbourne, FL 32904
Phone (321) 676-6650

2020 Commerce Dr
West Melbourne, FL 32904
Phone (321) 952-6000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1174823850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 COMMERCE DR",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329042335",
            "telephone_number": "321-722-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 COMMERCE DR",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329042335",
            "telephone_number": "321-722-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDIN",
        "first_name": "DAVINA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-27",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Melbourne, FL

Sources for this page

Verify at the official NPI Registry.