Michael Andrew Farris, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY10235 Issued in FL

Practice address

1881 NE 26TH St Ste 239
Wilton Manors, FL 33305-1426

Phone

(973) 865-0413

NPI assigned

Oct 12, 2009

Last updated

Nov 29, 2023By the provider in NPPES

Sex

Male

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

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jeffrey Shearer PA

  • Clinical Social Worker
  • Wilton Manors, FL
  • NPI 1982235362
  NPD
• Guardian Eldercare PC

  • Community/Behavioral Health Agency
  • Hackensack, NJ
  • NPI 1194888008
  NPD (past)

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1215262092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NE 26TH ST STE 239",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051426",
            "telephone_number": "973-865-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 NE 26TH ST STE 239",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051426",
            "telephone_number": "973-865-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-12",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Dawn Evans, MSW
• Rosenie Ezai-Gilles
• Patricia Falco, LMHC
• Joseph Fanfan Jr., M.D.
• David Farin, LMT
• Felice Fusca LCSW LLC
• Donald John Fensterman, LCSW
• Ferdinand Cabrera MD PA
• Arielvys Fernandez Febles, RDH
• Robert John Ferraiuolo, LMHC

• Clinical Psychologist in Wilton Manors, FL
• Providers in Wilton Manors, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.