Active NPI
Mind Body Psychology Services LLC
- Clinical Psychologist
- Jupiter, FL
National Provider Identifier
1396112157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 9109
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 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 DirectoryLocations
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.