Individual provider Active NPI

Alina Maria Clavijo, PH.D.

  • Psychologist
  • Miami, FL
National Provider Identifier
1396798351
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY10403 Issued in FL
Practice address
8362 SW 8TH St.
Miami, FL 33144-4180
Phone
(954) 374-3636
NPI assigned
May 18, 2006
Last updated
May 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20041364A IN
Psychologist 103T00000X PY10403 FL Primary
Cognitive & Behavioral Psychologist 103TB0200X PY10403 FL
Counseling Psychologist 103TC1900X PY10403 FL

Addresses

Primary practice location

8362 SW 8TH St.
Miami, FL 33144-4180

Mailing address

7775 Yardley Drive
Apt. F 105
Tamarac, FL 33321-0849
Phone (317) 370-5017

Other practice location 1

8805 N Meridian St
Indianapolis, IN 46260-2332
Phone (317) 706-7246

Other identifiers 1

IdentifierTypeStateIssuer
200247040MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20041364AINMDPsychologist
PY10403FLMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Psychologist Current Accepting new patients
Phoenix Psychsolutions LLC Psychologist CurrentSince May 4, 2019 Accepting new patients

Locations

8362 SW 8th St
West Miami, FL 33144
Phone (305) 269-6989

Interoperability endpoints

  • Direct secure messaging: alinaclavijopassik@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1396798351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7775 YARDLEY DRIVE",
            "address_2": "APT. F 105",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333210849",
            "telephone_number": "317-370-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8362 SW 8TH ST.",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331444180",
            "telephone_number": "954-374-3636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8805 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462602332",
            "country_code": "US",
            "telephone_number": "317-706-7246",
            "fax_number": "317-706-3419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAVIJO",
        "first_name": "ALINA",
        "middle_name": "MARIA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20041364A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY10403",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY10403",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY10403",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200247040",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.