Organization Active NPI

Center for Clinical & Forensic Psychology Inc

  • Clinical Psychologist
  • Plantation, FL
National Provider Identifier
1265459275
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY5318 Issued in FL
Legal business name
CENTER FOR CLINICAL & FORENSIC PSYCHOLOGY INC
Practice address
624 W Tropical Way
Plantation, FL 33317-3348
Phone
(954) 584-6155
Fax
(954) 316-7553
NPI assigned
Jul 16, 2006
Last updated
Dec 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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

Authorized official

Name
Ms. Jo-Anne Bliss, PSY.D.NPI 1942220918
Title
Clinical Director
Phone
(954) 584-6155

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 Psychologist 103TC0700X PY5318 FL Primary

Addresses

Primary practice location

624 W Tropical Way
Plantation, FL 33317-3348

Mailing address

624 W Tropical Way
Plantation, FL 33317-3348
Phone (954) 584-6155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040720000866 FL Part B Supplier - Clinic/Group Practice 9537149729 Receives reassigned benefits from 11 practitioners
Practice locations: Sunrise, FL; Pompano Beach, FL; Plantation, FL; Oakland Park, FL; Lauderdale Lakes, FL; N Miami Beach, FL; Margate, FL; Lauderhill, FL…

National Provider Directory

National Provider Directory

Locations

170 W 13th St
Hialeah, FL 33010
Phone (305) 885-2358

18 E 11th St
Hialeah, FL 33010
Phone (305) 883-8376

7463 NW 4th St
Plantation, FL 33317
Phone (954) 298-1273

295 SW 4th Ave
Pompano Beach, FL 33060
Phone (561) 960-2020

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1265459275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 W TROPICAL WAY",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333173348",
            "telephone_number": "954-584-6155",
            "fax_number": "954-316-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W TROPICAL WAY",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333173348",
            "telephone_number": "954-584-6155",
            "fax_number": "954-316-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR CLINICAL & FORENSIC PSYCHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "BLISS",
        "authorized_official_first_name": "JO-ANNE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "954-584-6155",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; 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.