Individual provider Active NPI

Elizabeth B Hooper

  • Clinical Psychologist
  • Port St Lucie, FL
National Provider Identifier
1386946374
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7942 Issued in FL
Practice address
2391 SW Madrid Rd
Port St Lucie, FL 34953-2114
Phone
(954) 616-9128
NPI assigned
Nov 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY7942 FL Primary

Addresses

Primary practice location

2391 SW Madrid Rd
Port St Lucie, FL 34953-2114

Mailing address

2391 SW Madrid Rd
Port St Lucie, FL 34953-2114
Phone (954) 616-9128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110113001105 FL Practitioner - Clinical Psychologist 8022207588 Practice locations: Port St Lucie, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2391 SW Madrid Rd
Port St Lucie, FL 34953-2114
Phone (772) 888-1628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY7942FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Transformative Healthcare Solutions East LLC Clinical PastSince May 1, 2017 Accepting new patients
Garnier Health Services Inc PastSince Feb 17, 2014 Accepting new patients
Pro Performance Physical Therapy LLC PastSince Jun 26, 2019 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1386946374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2391 SW MADRID RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532114",
            "telephone_number": "954-616-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2391 SW MADRID RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532114",
            "telephone_number": "954-616-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOPER",
        "first_name": "ELIZABETH",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.