Atlantic Neuropsychology

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

ATLANTIC NEUROPSYCHOLOGY

Practice address

930 S Harbor City Blvd Ste 402
Melbourne, FL 32901-1967

Phone

(321) 379-3799

Fax

(321) 379-3790

NPI assigned

Jul 27, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Julie L Delettre, PSY.D.NPI 1588913735

Title

Owner/Operator Neuropsychologist

Phone

(321) 379-3799

Specialties & licenses 1

Addresses

Other names 1

• Julie L. DeLettre, Psy.D. Other name

Locations

Practitioners 1

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

• Julie L Delettre, PSY.D.

  • Psychologist
  • Melbourne, FL
  • NPI 1588913735

  Clinical Neuropsychologist

  NPD Authorized official

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1275214868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2984 TUSCARORA CT",
            "address_2": "C/O JULIE L. DELETTRE, PSY.D.",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329048098",
            "telephone_number": "321-379-3799",
            "fax_number": "321-379-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S HARBOR CITY BLVD STE 402",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011967",
            "telephone_number": "321-379-3799",
            "fax_number": "321-379-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC NEUROPSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "DELETTRE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/OPERATOR NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "321-379-3799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Julie L. DeLettre, Psy.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Atlantic Surgery & Laser Center LLC

• All providers in Melbourne, FL
• Clinical Neuropsychologist in Florida

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