NPIMap

Organization Active NPI

Psychiatry Wellness Center PA

  • Psychiatry Physician
  • Greenacres, FL
National Provider Identifier
1386271849
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHIATRY WELLNESS CENTER PA
Practice address
6801 Lake Worth Rd Ste 213-214
Greenacres, FL 33467-2955
Phone
(561) 444-2351
Fax
(561) 469-7089
NPI assigned
Mar 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Authorized official

Name
Janell Lynn Tabora, MDNPI 1811334410
Title
Director
Phone
(602) 696-9272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

6801 Lake Worth Rd Ste 213-214
Greenacres, FL 33467-2955

Mailing address

6801 Lake Worth Rd Ste 213-214
Lake Worth, FL 33467-2955
Phone (561) 444-2351

Other identifiers 1

IdentifierTypeStateIssuer
107183900MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stevem@psychiatrywellness.com

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22901/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

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": "1585094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1386271849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD STE 213-214",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672955",
            "telephone_number": "561-444-2351",
            "fax_number": "561-469-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD STE 213-214",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672955",
            "telephone_number": "561-444-2351",
            "fax_number": "561-469-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRY WELLNESS CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-25",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "TABORA",
        "authorized_official_first_name": "JANELL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-696-9272",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107183900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stevem@psychiatrywellness.com",
            "affiliation": "N",
            "address_1": "6801 Lake Worth Rd",
            "address_2": "Suite 213-214",
            "city": "Lake Worth",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.