Nicholas Joseph, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY11985 Issued in FL

Practice address

1520 S Grant St
Longwood, FL 32750-6538

Phone

(718) 362-1411

Fax

(718) 414-1651

NPI assigned

Sep 12, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Networks

• Freedom Health HMO Network

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

• Balanced Wellbeing LLC

  • Psychiatry Physician
  • Ocala, FL
  • NPI 1336513639
  NPD

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1184401200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CORPORATE WAY STE 2M",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892027",
            "telephone_number": "718-362-1411",
            "fax_number": "718-414-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S GRANT ST",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506538",
            "telephone_number": "718-362-1411",
            "fax_number": "718-414-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "NICHOLAS",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maylynn Jones, MSW
• Shawntrece Jones
• Tina Marie Jones, ARNP
• Abigail Joseph
• Daniel Alexander Joseph, M.ED., LMHC
• Sumire Joseph
• Susan Carol Joseph, PT
• Tasandra Joseph, MSW
• Journey Counseling Services Inc.
• Joy & John LLC

• Clinical Psychologist in Longwood, FL
• Providers in Longwood, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.