NPIMap

Organization Active NPI

Kristina McMenamy PSYD LLC

  • Clinical Psychologist
  • Grant, FL
National Provider Identifier
1417195306
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7481 Issued in FL
Legal business name
KRISTINA MCMENAMY PSYD LLC
Practice address
1845 Cypress Lake Dr
Grant, FL 32949-5330
Phone
(772) 607-2293
NPI assigned
Jan 30, 2009
Last updated
Jan 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Authorized official

Name
Dr. Kristina Anne McMenamy, PSYDNPI 1437359916
Title
Member
Phone
(772) 607-2293

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY7481 FL Primary

Addresses

Primary practice location

1845 Cypress Lake Dr
Grant, FL 32949-5330

Mailing address

1845 Cypress Lake Dr
Grant, FL 32949-5330
Phone (772) 607-2293

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1417195306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 CYPRESS LAKE DR",
            "city": "GRANT",
            "state": "FL",
            "postal_code": "329495330",
            "telephone_number": "772-607-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 CYPRESS LAKE DR",
            "city": "GRANT",
            "state": "FL",
            "postal_code": "329495330",
            "telephone_number": "772-607-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTINA MCMENAMY PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "MCMENAMY",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "772-607-2293",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grant, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.