Active NPI
Lacey Amanda Prine
- School Psychologist
- Tampa, FL
National Provider Identifier
1336836279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- SS1375
- Practice address
- 1802 N Armenia Ave
Tampa, FL 33607-3406 - Phone
- (813) 444-8760
- NPI assigned
- Apr 20, 2023
- Last updated
- Apr 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SS1375 | FL | Primary |
Addresses
Primary practice location
1802 N Armenia Ave
Tampa, FL 33607-3406
Mailing address
10863 Boyette Rd
Riverview, FL 33569-8012
Phone (813) 444-8760
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
| License | State | Type | Specialty |
|---|---|---|---|
| SS1375 | FL | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Monica Lake, PLLC | Current | Accepting new patients | |
| Dr. Lake and Associates | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Brandon, FL
- NPI 1689528846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681948800000",
"number": "1336836279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10863 BOYETTE RD",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335698012",
"telephone_number": "813-444-8760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 N ARMENIA AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336073406",
"telephone_number": "813-444-8760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRINE",
"first_name": "LACEY",
"middle_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-20",
"last_updated": "2023-04-20",
"certification_date": "2023-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "FL",
"license": "SS1375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.