Individual provider Active NPI

Sophia Demorizi, PSYD

  • Clinical Psychologist
  • Fort Lauderdale, FL
National Provider Identifier
1194294736
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
023351 Issued in NY
Practice address
1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875
Phone
(954) 885-9500
NPI assigned
Nov 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY10319 FL
Clinical Psychologist 103TC0700X 023351 NY Primary

Addresses

Primary practice location

1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875

Mailing address

3512 Quentin Rd Ste 110
Brooklyn, NY 11234-4245
Phone (305) 962-3385

Other practice location 1

3512 Quentin Rd Ste 110
Brooklyn, NY 11234-4245
Phone (305) 962-3385

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY10319FLMDClinical Psychologist
023351NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy Psychology of New York PLLC Clinical CurrentSince Oct 7, 2021 Accepting new patients
MHH Psychology and Speech-Language Pathology Therapy Services PLLC Single Specialty CurrentSince Oct 1, 2021 Accepting new patients
Pro Performance Physical Therapy LLC Single Specialty PastSince Jun 26, 2019 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

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": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1194294736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD STE 110",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344245",
            "telephone_number": "305-962-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 SE 1ST AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162875",
            "telephone_number": "954-885-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3512 Quentin Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112344245",
            "country_code": "US",
            "telephone_number": "305-962-3385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMORIZI",
        "first_name": "SOPHIA",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10319",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "023351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.