NPIMap

Organization Active NPI

Behavioral Health Practitioner's, Inc.

  • Clinical Psychologist
  • Largo, FL
National Provider Identifier
1194935775
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY2716 Issued in FL
Legal business name
BEHAVIORAL HEALTH PRACTITIONER'S, INC.
Practice address
1301 Seminole Blvd
B-112
Largo, FL 33770-8124
Phone
(727) 518-7294
Fax
(727) 584-4937
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gerard E Boutin, PH.D.NPI 1083749386
Title
President
Phone
(727) 518-7294

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY2716 FL Primary

Addresses

Primary practice location

1301 Seminole Blvd
B-112
Largo, FL 33770-8124

Mailing address

1301 Seminole Blvd
B-112
Largo, FL 33770-8124
Phone (727) 518-7294

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194935775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SEMINOLE BLVD",
            "address_2": "B-112",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337708124",
            "telephone_number": "727-518-7294",
            "fax_number": "727-584-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SEMINOLE BLVD",
            "address_2": "B-112",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337708124",
            "telephone_number": "727-518-7294",
            "fax_number": "727-584-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH PRACTITIONER'S, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOUTIN",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-518-7294",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.