Individual provider Active NPI

George Zaky, PSY.D., LMHC

  • Forensic Psychologist
  • Port Saint Lucie, FL
National Provider Identifier
1194949495
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
PY8016 Issued in FL
Practice address
447 NW Prima Vista Blvd
Port Saint Lucie, FL 34983-8731
Phone
(772) 249-2593
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH9083 FL
Clinical Neuropsychologist 103G00000X PY8016 FL
Psychologist 103T00000X PY8016 FL
Cognitive & Behavioral Psychologist 103TB0200X PY8016 FL
Clinical Psychologist 103TC0700X PY8016 FL
Forensic Psychologist 103TF0200X PY8016 FL Primary

Addresses

Primary practice location

447 NW Prima Vista Blvd
Port Saint Lucie, FL 34983-8731

Mailing address

447 NW Prima Vista Blvd
Port Saint Lucie, FL 34983-8731
Phone (772) 249-2593

Other practice location 1

341 SE 2nd St
Belle Glade, FL 33430-3509
Phone (772) 249-2593

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
MH9083FLMDMental Health Counselor
PY8016FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Expert Psychological Associates, LLC Clinical CurrentSince Jun 30, 2011 Accepting new patients

Locations

341 SE 2nd St
Belle Glade, FL 33430
Phone (772) 249-2593

447 NW Prima Vista Blvd
Port Saint Lucie, FL 34983
Phone (772) 249-2593

1680 SW Bayshore Blvd
Ste 116
Port St Lucie, FL 34984
Phone (561) 951-8443

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194949495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 NW PRIMA VISTA BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349838731",
            "telephone_number": "772-249-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 NW PRIMA VISTA BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349838731",
            "telephone_number": "772-249-2593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "341 SE 2nd St",
            "address_purpose": "LOCATION",
            "city": "Belle Glade",
            "state": "FL",
            "postal_code": "334303509",
            "country_code": "US",
            "telephone_number": "772-249-2593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAKY",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9083",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY8016",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8016",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY8016",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8016",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "FL",
            "license": "PY8016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.