Bird of Paradise Psychological Services PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY6151 Issued in FL

Legal business name

BIRD OF PARADISE PSYCHOLOGICAL SERVICES PA

Practice address

7051 W. Commercial Blvd
Suite #3a
Tamarac, FL 33319-2146

Phone

(954) 720-0412

Fax

(954) 720-0824

NPI assigned

Jun 26, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Karlin Antoinette Donegal, PH.D.NPI 1770670549

Title

Owner, Ceo, Cfo

Phone

(954) 720-0412

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 5

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

• Karlin Antoinette Donegal, PH.D.

  • Clinical Psychologist
  • Tamarac, FL
  • NPI 1770670549
  Medicare reassignment NPD Authorized official
• Miriam Jocelyn Rodriguez, PHD

  • Clinical Neuropsychologist
  • Doral, FL
  • NPI 1619398419
  Medicare reassignment NPD
• Ladonna Dahl, PSY.D.

  • Clinical Psychologist
  • Lantana, FL
  • NPI 1215252911
  NPD (past)
• Heather Nicolle Kuhl, PSY.D.

  • Clinical Psychologist
  • Lauderhill, FL
  • NPI 1609202464
  NPD (past)
• Caren Elizabeth Longsworth, LCSW

  • Clinical Social Worker
  • Wilton Manors, FL
  • NPI 1215083423
  NPD (past)

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1184886624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7051 W. COMMERCIAL BLVD",
            "address_2": "SUITE #3A",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192146",
            "telephone_number": "954-720-0412",
            "fax_number": "954-720-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7051 W. COMMERCIAL BLVD",
            "address_2": "SUITE #3A",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192146",
            "telephone_number": "954-720-0412",
            "fax_number": "954-720-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIRD OF PARADISE PSYCHOLOGICAL SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "DONEGAL",
        "authorized_official_first_name": "KARLIN",
        "authorized_official_middle_name": "ANTOINETTE",
        "authorized_official_title_or_position": "OWNER, CEO, CFO",
        "authorized_official_telephone_number": "954-720-0412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daphnie Vanessa Bharadwa, ARNP
• Bienestar Vitality Healthcare Services
• Billing Service of Florida
• Bio-Behavioral Corp.
• Bio-Medical Applications of Florida, Inc.
• Thomas Bizzarro, MSW
• Tatyana Blackmon, LCSW
• Kelly Lauraine Blake Frances, PT, DPT
• Ricardo Blanc
• Blue Ribbon Care Assisted Living Facility III, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.