Mindscope Clinic LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MINDSCOPE CLINIC LLC

Practice address

3680 Avalon Park East Blvd Ste 203
Orlando, FL 32828-9372

Phone

(321) 340-3038

Fax

(407) 604-6671

NPI assigned

Sep 20, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Carolina Henao Irurita, PH.DNPI 1518315373

Title

Licensed Psychologist

Phone

(321) 287-0325

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carolina Henao Irurita, PH.D.

  • Clinical Psychologist
  • Orlando, FL
  • NPI 1518315373

  Behavior Analyst

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1396523254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12425 MARLEIGH CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 AVALON PARK EAST BLVD STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328289372",
            "telephone_number": "321-340-3038",
            "fax_number": "407-604-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDSCOPE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "IRURITA",
        "authorized_official_first_name": "CAROLINA",
        "authorized_official_middle_name": "HENAO",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "321-287-0325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Orlando, FL
• Providers in Orlando, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.