Active NPI
James Bruce Levasseur, PH.D.
- Clinical Neuropsychologist
- Temple Terrace, FL
National Provider Identifier
1407067143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PY 5991
- Practice address
- 12909 N 56TH St
Suite 209
Temple Terrace, FL 33617-1275 - Phone
- (813) 980-2094
- Fax
- (813) 980-2094
- NPI assigned
- May 24, 2007
- Last updated
- Oct 24, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PY 5991 | FL | Primary |
| Cognitive & Behavioral Psychologist | 103TB0200X | PY 5991 | FL | |
| Clinical Psychologist | 103TC0700X | PY 5991 | FL | |
| Forensic Psychologist | 103TF0200X | PY 5991 | FL |
Addresses
Primary practice location
12909 N 56TH St
Suite 209
Temple Terrace, FL 33617-1275
Mailing address
507 Lakeshore Dr
Eustis, FL 32726-4026
Phone (813) 598-3259
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY 5991 | FL | MD | Cognitive & Behavioral Psychologist |
Organizations & group practices 1
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.
-
- Forensic Psychologist
- Temple Terrace, FL
- NPI 1083825723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540339200000",
"number": "1407067143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 LAKESHORE DR",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327264026",
"telephone_number": "813-598-3259",
"fax_number": "407-374-5112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12909 N 56TH ST",
"address_2": "SUITE 209",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336171275",
"telephone_number": "813-980-2094",
"fax_number": "813-980-2094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVASSEUR",
"first_name": "JAMES",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2018-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "FL",
"license": "PY 5991",
"primary": true
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "FL",
"license": "PY 5991",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY 5991",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "FL",
"license": "PY 5991",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Temple Terrace, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.