Stephanie Thadal

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11031757 Issued in FL

Practice address

1555 NW Saint Lucie West Blvd
Port Saint Lucie, FL 34986-1758

Phone

(772) 303-1148

NPI assigned

Mar 22, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thrive Behavioral Sciences- Orlando LLCGroup PAC ID 9739420654, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Thrive Behavioral Sciences Orlando LLC

  • Geriatric Psychiatry Physician
  • Orlando, FL
  • NPI 1063979730
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NY, Psychiatric/Mental Health

  Medicare reassignment NPD
• South Broward Hospital District

  • Critical Care Medicine (Internal Medicine) Physician
  • Hollywood, FL
  • NPI 1609884154
  Medicare reassignment
• South Broward Hospital District

  • Home Infusion Therapy Pharmacy
  • Miramar, FL
  • NPI 1043656614
  NPD
• South Broward Hospital District

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1134102080
  NPD

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1235989393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NW SAINT LUCIE WEST BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861758",
            "telephone_number": "954-417-5985",
            "fax_number": "754-339-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 NW SAINT LUCIE WEST BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861758",
            "telephone_number": "772-303-1148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13101 40th Rd Apt 15C",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113545245",
            "country_code": "US",
            "telephone_number": "954-417-5985",
            "fax_number": "754-339-0006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THADAL",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-22",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406512",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11031757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Andrew Tellinghuisen, PHARMD
• Tender Touch Caregivers LLC
• Tending Heart Counselling LLC
• Felicia Termine-Bonner, RN, IBCLC
• Cesara Terry
• The Academy at Ambrosia LLC
• The Cornerstones of Port St. Lucie, Inc.
• The Cornerstones of Port St. Lucie, Inc.
• The Cornerstones of Port St. Lucie, Inc.
• The Gift House Inc

• Psychiatric/Mental Health Nurse Practitioner in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.