Active NPI
Larisa M. Palmer, PSY.D.
- Clinical Psychologist
- Hollywood, FL
National Provider Identifier
1366715591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY7753
- Practice address
- 210 S Federal Hwy Ste 302
Hollywood, FL 33020-6811 - Phone
- (954) 925-3191
- Fax
- (954) 925-3193
- NPI assigned
- Feb 19, 2012
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY7753 | FL | Primary |
Addresses
Primary practice location
210 S Federal Hwy Ste 302
Hollywood, FL 33020-6811
Mailing address
210 S Federal Hwy Ste 302
Hollywood, FL 33020-6811
Phone (954) 925-3191
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 |
|---|---|---|---|
| PY7753 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329609600000",
"number": "1366715591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 S FEDERAL HWY STE 302",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330206811",
"telephone_number": "954-925-3191",
"fax_number": "954-925-3193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 S FEDERAL HWY STE 302",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330206811",
"telephone_number": "954-925-3191",
"fax_number": "954-925-3193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "LARISA",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-19",
"last_updated": "2012-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY7753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.