Organization Active NPI

Kerrianne Bresnan, Psy.D., LLC

  • Clinical Neuropsychologist
  • Fort Lauderdale, FL
National Provider Identifier
1366780553
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY 7948 Issued in FL
Legal business name
KERRIANNE BRESNAN, PSY.D., LLC
Practice address
3471 N Federal Hwy Ste 508
Fort Lauderdale, FL 33306-1052
Phone
(954) 321-1980
NPI assigned
Jan 22, 2013
Last updated
Nov 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Authorized official

Name
Dr. Kerri Bresnan, PSY.D.
Title
Managing Member
Phone
(954) 321-1980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X PY 7948 FL Primary

Addresses

Primary practice location

3471 N Federal Hwy Ste 508
Fort Lauderdale, FL 33306-1052

Mailing address

3471 N Federal Hwy Ste 508
Fort Lauderdale, FL 33306-1052
Phone (954) 321-1980

National Provider Directory

National Provider Directory

Locations

5353 N Federal Hwy
Ste 208
Fort Lauderdale, FL 33308
Phone (954) 296-1048

5353 N Federal Hwy
Ste 404
Ft Lauderdale, FL 33308
Phone (954) 321-1980

400 NW 74th Ave
Plantation, FL 33317
Phone (954) 321-1980

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1366780553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3471 N FEDERAL HWY STE 508",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061052",
            "telephone_number": "954-321-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3471 N FEDERAL HWY STE 508",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061052",
            "telephone_number": "954-321-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRIANNE BRESNAN, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "BRESNAN",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "954-321-1980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY 7948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.