NPIMap

Organization Active NPI

My Psy LLC

  • Psychologist
  • Phenix City, AL
National Provider Identifier
1194130435
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
748 Issued in AL
Legal business name
MY PSY LLC
Practice address
1200 14TH St
Suite a
Phenix City, AL 36867-4907
Phone
(334) 297-4418
NPI assigned
Jun 25, 2014
Last updated
Jun 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Authorized official

Name
Dr. Donna Susanne Fleitas, PHDNPI 1730231903
Title
Psychologist
Phone
(334) 297-4418

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 748 AL Primary

Addresses

Primary practice location

1200 14TH St
Suite a
Phenix City, AL 36867-4907

Mailing address

1200 14TH St
Suite a
Phenix City, AL 36867-4907

National Provider Directory

National Provider Directory

Locations

1200 14th St
Ste A
Phenix City, AL 36867
Phone (205) 821-1607

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1194130435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 14TH ST",
            "address_2": "SUITE A",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368674907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 14TH ST",
            "address_2": "SUITE A",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368674907",
            "telephone_number": "334-297-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PSY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "FLEITAS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "SUSANNE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "334-297-4418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "AL",
            "license": "748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phenix City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.