Individual provider Active NPI

Amy Lynn Solderich, PSY.D.

  • Clinical Psychologist
  • Vero Beach, FL
National Provider Identifier
1215287438
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9632 Issued in FL
Practice address
1701 Highway A1A Ste 216
Vero Beach, FL 32963-2250
Phone
(772) 925-1121
Fax
(772) 925-1015
NPI assigned
Sep 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X 9632 FL Primary

Addresses

Primary practice location

1701 Highway A1A Ste 216
Vero Beach, FL 32963-2250

Mailing address

1701 Highway A1A Ste 216
Vero Beach, FL 32963-2250
Phone (772) 925-1121

Other practice location 1

1702 Club Dr
Vero Beach, FL 32963-2258
Phone (772) 222-5001

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
I20230203001534 FL Practitioner - Clinical Psychologist 4183965700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1701 Hwy A1A
Suite 216
Vero Beach, FL 32963-2250

4625 Hwy A1A
Suite 8
Vero Beach, FL 32963-1364
Phone (772) 925-1121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9632FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Seaside Psychological Services, LLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

1701 Highway A1A
Ste 216
Vero Beach, FL 32963
Phone (772) 925-1121

4625 Highway A1A
Ste 8
Vero Beach, FL 32963
Phone (772) 925-1121

1705 19th Pl
Ste E2
Vero Beach, FL 32960
Phone (727) 257-5995

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": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1215287438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 HIGHWAY A1A STE 216",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329632250",
            "telephone_number": "772-925-1121",
            "fax_number": "772-925-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 HIGHWAY A1A STE 216",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329632250",
            "telephone_number": "772-925-1121",
            "fax_number": "772-925-1015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1702 Club Dr",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329632258",
            "country_code": "US",
            "telephone_number": "772-222-5001",
            "fax_number": "772-492-3786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLDERICH",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "9632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.