Individual provider Active NPI

Elizabeth Justine Devlin, PH.D.

  • Psychologist
  • Tampa, FL
National Provider Identifier
1194398099
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY11145 Issued in FL
Practice address
205 S Hoover Blvd Ste 202
Tampa, FL 33609-3574
Phone
(813) 563-1155
Fax
(813) 602-0216
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY11145 FL Primary

Addresses

Primary practice location

205 S Hoover Blvd Ste 202
Tampa, FL 33609-3574

Mailing address

205 S Hoover Blvd
Ste 202
Tampa, FL 33609-3574
Phone (813) 563-1155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210915000022 FL Practitioner - Clinical Psychologist 2466858592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Psychological Services, PLLCGroup PAC ID 4587969977, 15 clinicians

Practice addresses (Care Compare)

205 S Hoover Blvd
Suite 202
Tampa, FL 33609-3574
Phone (813) 563-1155

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY11145FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Psychological Services PLLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

3637 4th St N
Ste 390
St Petersburg, FL 33704
Phone (727) 310-5520

205 S Hoover Blvd
Ste 202
Tampa, FL 33609
Phone (813) 563-1155

Organizations & group practices 1

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1194398099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S HOOVER BLVD",
            "address_2": "STE 202",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093574",
            "telephone_number": "813-563-1155",
            "fax_number": "813-602-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S HOOVER BLVD STE 202",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093574",
            "telephone_number": "813-563-1155",
            "fax_number": "813-602-0216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVLIN",
        "first_name": "ELIZABETH",
        "middle_name": "JUSTINE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY11145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.