Organization Active NPI

Mind Body Psychology Services LLC

  • Clinical Psychologist
  • Jupiter, FL
National Provider Identifier
1396112157
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 9109 Issued in FL
Legal business name
MIND BODY PSYCHOLOGY SERVICES LLC
Practice address
4600 Military TRL Ste 103
Jupiter, FL 33458-4811
Phone
(561) 249-7400
NPI assigned
Aug 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Authorized official

Name
Dr. Lisa Smalheiser, PSY.D.
Title
Clinical Psychologist
Phone
(954) 829-2975

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY 9109 FL Primary

Addresses

Primary practice location

4600 Military TRL Ste 103
Jupiter, FL 33458-4811

Mailing address

4600 Military TRL Ste 103
Jupiter, FL 33458-4811
Phone (561) 249-7400

Other practice location 1

759 SW Federal Hwy Ste 203
Stuart, FL 34994-2972
Phone (954) 800-2762

National Provider Directory

National Provider Directory

Locations

759 SW Federal Hwy
Ste 203
Stuart, FL 34994
Phone (772) 219-0779

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1396112157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRL STE 103",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584811",
            "telephone_number": "561-249-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRL STE 103",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584811",
            "telephone_number": "561-249-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 SW Federal Hwy Ste 203",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349942972",
            "country_code": "US",
            "telephone_number": "954-800-2762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND BODY PSYCHOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "SMALHEISER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "954-829-2975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 9109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.