Organization Active NPI

Judith Carney PSYD LLC

  • Clinical Psychologist
  • Port Saint Lucie, FL
National Provider Identifier
1245744507
Registry record updated Nov 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY9240 Issued in FL
Legal business name
JUDITH CARNEY PSYD LLC
Practice address
245 SW North Wakefield Cir
Port Saint Lucie, FL 34953-5443
Phone
(561) 577-2352
NPI assigned
Nov 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2017

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

Authorized official

Name
Dr. Judith Helene Carney, PSYDNPI 1659785947
Title
Owner
Phone
(561) 577-2352

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY9240 FL Primary

Addresses

Primary practice location

245 SW North Wakefield Cir
Port Saint Lucie, FL 34953-5443

Mailing address

245 SW North Wakefield Cir
Port Saint Lucie, FL 34953-5443
Phone (561) 577-2352

Other names 1

  • Judith Carney PsyD LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180301001374 FL Part B Supplier - Clinic/Group Practice 8921369224 Receives reassigned benefits from 1 practitioner
Practice locations: West Palm Beach, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1511481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511481600000",
    "number": "1245744507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 SW NORTH WAKEFIELD CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535443",
            "telephone_number": "561-577-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 SW NORTH WAKEFIELD CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535443",
            "telephone_number": "561-577-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDITH CARNEY PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-24",
        "last_updated": "2017-11-24",
        "status": "A",
        "authorized_official_last_name": "CARNEY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "HELENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-577-2352",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Judith Carney PsyD LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.