Child & Adolescent Treatment Center

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY6399 Issued in FL

Legal business name

CHILD & ADOLESCENT TREATMENT CENTER

Practice address

1950 Lee Rd
Suite 202
Winter Park, FL 32789-1859

Phone

(407) 739-5874

Fax

(407) 644-1292

NPI assigned

Aug 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert C Coolidge

Title

Agent/Representative

Phone

(386) 774-5211

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Krissa E Kirby Other name

Locations

Practitioners 1

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

• Krissa Kirby, PH.D

  • Clinical Psychologist
  • Grand Rapids, MI
  • NPI 1386639870

  Clinical Child & Adolescent

  NPD (past)

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1306039243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741240",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327741240",
            "telephone_number": "386-774-5211",
            "fax_number": "386-774-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 LEE RD",
            "address_2": "SUITE 202",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891859",
            "telephone_number": "407-739-5874",
            "fax_number": "407-644-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD & ADOLESCENT TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "COOLIDGE",
        "authorized_official_first_name": "ROBERT C",
        "authorized_official_title_or_position": "AGENT/REPRESENTATIVE",
        "authorized_official_telephone_number": "386-774-5211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY6399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE SHIELD",
            "identifier": "54725",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Krissa E Kirby",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wanyan Chen
• Emily Marie Cherry, APRN
• Michael C Cherry, PA-C
• Mollida Chhay, PHARMD
• Yuwei CHI, PHD
• Timothy Charles Childers, M.D.
• Children'S Home Society
• Children'S Home Society of Florida, Inc
• Childrens Home Society
• Gerald Douglas Chiles

• Clinical Child & Adolescent Psychologist in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Clinical Child & Adolescent Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.