Individual provider Active NPI

Debra Ann Stein, PH.D.

  • Clinical Psychologist
  • Boca Raton, FL
National Provider Identifier
1184836892
Registry record updated Feb 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7133 Issued in FL
Practice address
950 Peninsu;la Corporate Circle
Suite 3000
Boca Raton, FL 33487
Phone
(561) 999-8881
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY7133 FL Primary
Clinical Psychologist 103TC0700X 35S100346000 NJ

Addresses

Primary practice location

950 Peninsu;la Corporate Circle
Suite 3000
Boca Raton, FL 33487

Mailing address

7201 N.E. Bay Harbour Ave.
Boca Raton, FL 33487-1707
Phone (561) 998-9040

Other identifiers 1

IdentifierTypeStateIssuer
75022AOtherFLBLUE CROSS BLUE SHIELD FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2023 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35S100346000NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mauro Reynolds & Associates in Counseling Inc Clinical Past Accepting new patients
Cme Psychology Consultants PA Clinical PastSince Jan 2, 2012 Accepting new patients
Abbe Polsyn PSYD PA Clinical Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1184836892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 N.E. BAY HARBOUR AVE.",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334871707",
            "telephone_number": "561-998-9040",
            "fax_number": "561-998-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 PENINSU;LA CORPORATE CIRCLE",
            "address_2": "SUITE 3000",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33487",
            "telephone_number": "561-999-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7133",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100346000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "75022A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.