Individual provider Active NPI

Judith Faith Legault, PH.D., ED.D.

  • Clinical Psychologist
  • Orlando, FL
National Provider Identifier
1295163384
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 8889 Issued in FL
Practice address
5201 Raymond St
Orlando, FL 32803-8208
Phone
(321) 397-6159
NPI assigned
Oct 29, 2013
Last updated
Oct 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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 PY 8889 FL Primary

Addresses

Primary practice location

5201 Raymond St
Orlando, FL 32803-8208

Mailing address

810 Point Pleasant PL
Altamonte Springs, FL 32701-6218
Phone (407) 595-5176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231102001381 FL Practitioner - Clinical Psychologist 9133575798 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Transformative Healthcare Solutions IncGroup PAC ID 8921337973, 27 clinicians

Practice addresses (Care Compare)

160 Treemonte Dr
Orange City, FL 32763-7953
Phone (954) 885-9500

1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875
Phone (954) 885-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY 8889FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Transformative Healthcare Solutions North LLC Clinical CurrentSince Jan 2, 2025 Accepting new patients
Transformative Healthcare Solutions South LLC Clinical CurrentSince Jan 2, 2025 Accepting new patients
Transformative Healthcare Solutions Central LLC Clinical CurrentSince Jan 2, 2025 Accepting new patients
Transformative Healthcare Solutions Inc Clinical CurrentSince Oct 19, 2023 Accepting new patients
Mental Health Center of Florida PA Clinical CurrentSince Jun 19, 2024 Accepting new patients
Transformative Healthcare Solutions West LLC Clinical CurrentSince Jan 2, 2025 Accepting new patients
Transformative Healthcare Solutions Gold Coast LLC Clinical CurrentSince Jan 2, 2025 Accepting new patients
Transformative Healthcare Solutions East LLC Clinical CurrentSince Jan 2, 2025 Accepting new patients
Pro Performance Physical Therapy LLC PastSince Jun 26, 2019 Accepting new patients

Locations

1321 NE 24th Ave
Cape Coral, FL 33909
Phone (239) 294-2180

2544 E Sunrise Blvd
Fort Lauderdale, FL 33304
Phone (954) 253-0853

1848 SE 1st Ave
Ft Lauderdale, FL 33316
Phone (954) 366-2700

4243 Sunbeam Rd
Ste 8
Jacksonville, FL 32257

160 Treemonte Dr
Orange City, FL 32763
Phone (386) 423-0505

9381 US Highway 19 N
Pinellas Park, FL 33782
Phone (727) 220-0302

4820 W Gandy Blvd
Tampa, FL 33611

3710 14th St
Vero Beach, FL 32960
Phone (772) 564-0063

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1295163384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 POINT PLEASANT PL",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327016218",
            "telephone_number": "407-595-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 RAYMOND ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328038208",
            "telephone_number": "321-397-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGAULT",
        "first_name": "JUDITH",
        "middle_name": "FAITH",
        "credential": "PH.D., ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 8889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.