Individual provider Active NPI

Jeanne Trifone, PSYD

  • Clinical Psychologist
  • Port Charlotte, FL
National Provider Identifier
1366565210
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY10098 Issued in FL
Practice address
1777 Tamiami TRL Ste 304-2
Port Charlotte, FL 33948-4088
Phone
(941) 740-2140
Fax
(941) 740-2140
NPI assigned
Apr 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20040996 IN
Clinical Psychologist 103TC0700X PY10098 FL Primary

Addresses

Primary practice location

1777 Tamiami TRL Ste 304-2
Port Charlotte, FL 33948-4088

Mailing address

1777 Tamiami TRL Ste 304-2
Port Charlotte, FL 33948-4088
Phone (941) 740-2140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111013000667 IN Practitioner - Clinical Psychologist 7719948843 Reassigns benefits to 1 organization
I20240417000198 FL Practitioner - Clinical Psychologist 7719948843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1777 Tamiami TRL
Suite 304 2
Port Charlotte, FL 33948-4088
Phone (941) 740-2140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY10098FLMDClinical Psychologist
20040996INMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Challenges of Life Counseling LLC Clinical CurrentSince Apr 1, 2024 Accepting new patients
Duneland Counseling Center, Inc. Clinical CurrentSince Mar 1, 1999 Accepting new patients

Locations

1777 Tamiami Trl
Ste 3042
Port Charlotte, FL 33948

1777 Tamiami Trl
Ste 304-2
Port Charlotte, FL 33948
Phone (941) 740-2140

215 W Indiana Ave
Chesterton, IN 46304
Phone (219) 921-0705

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": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1366565210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 TAMIAMI TRL STE 304-2",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339484088",
            "telephone_number": "941-740-2140",
            "fax_number": "941-732-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 TAMIAMI TRL STE 304-2",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339484088",
            "telephone_number": "941-740-2140",
            "fax_number": "941-740-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIFONE",
        "first_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040996",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.