Individual provider Active NPI

Douglas B Shoumaker, LSP, NCSP

  • Psychologist
  • Miami, FL
National Provider Identifier
1356710339
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
SS1233 Issued in FL
Practice address
7001 SW 97TH Ave Ste 206
Miami, FL 33173-1410
Phone
(850) 207-7560
Fax
(786) 400-2134
NPI assigned
Sep 19, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X SS1233 FL Primary

Addresses

Primary practice location

7001 SW 97TH Ave Ste 206
Miami, FL 33173-1410

Mailing address

7001 SW 97TH Ave Ste 206
Miami, FL 33173-1410
Phone (850) 207-7560

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

LicenseStateTypeSpecialty
SS1233FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adolescent Psychological and Counseling Services of NW Florida, LLC Psychologist Current Accepting new patients
Academic, Behavioral, and Cognitive Testing Services LLC Psychologist PastSince Oct 5, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1356710339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 SW 97TH AVE STE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331731410",
            "telephone_number": "850-207-7560",
            "fax_number": "786-400-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 SW 97TH AVE STE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331731410",
            "telephone_number": "850-207-7560",
            "fax_number": "786-400-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUMAKER",
        "first_name": "DOUGLAS",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "LSP, NCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-19",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "SS1233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.