Theresa Newell, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY8615 Issued in FL

Practice address

3595 Sheridan St
Suite #103
Hollywood, FL 33021-3657

Phone

(954) 981-8200

Fax

(954) 272-8043

NPI assigned

Nov 9, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1205180494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 N FEDERAL HWY",
            "address_2": "SUITE #42",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334315187",
            "telephone_number": "954-981-8200",
            "fax_number": "954-272-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 SHERIDAN ST",
            "address_2": "SUITE #103",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213657",
            "telephone_number": "954-981-8200",
            "fax_number": "954-272-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWELL",
        "first_name": "THERESA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.