Individual provider Active NPI

Venise Predestin Carrier

  • Clinical Psychologist
  • South Miami, FL
National Provider Identifier
1245937804
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY11780 Issued in FL
Practice address
7600 S Red Rd Ste 200
South Miami, FL 33143-5403
Phone
(786) 508-2207
NPI assigned
Feb 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY11780 FL Primary

Addresses

Primary practice location

7600 S Red Rd Ste 200
South Miami, FL 33143-5403

Mailing address

218 N 26TH Ave
Hollywood, FL 33020-4841
Phone (754) 242-2609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PY11780FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Luna Psychology Group, P.a. PastSince Feb 19, 2023 Accepting new patients

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": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1245937804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 N 26TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204841",
            "telephone_number": "754-242-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 S RED RD STE 200",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435403",
            "telephone_number": "786-508-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREDESTIN CARRIER",
        "first_name": "VENISE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.