Individual provider Active NPI

Parker Lee Mott, PSY.D.

  • Clinical Psychologist
  • Winter Garden, FL
National Provider Identifier
1417378910
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY8941 Issued in FL
Practice address
310 S. Dillard Street
Suite 190
Winter Garden, FL 34787
Phone
(407) 347-0661
Fax
(407) 347-0664
NPI assigned
Dec 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY8941 FL
Cognitive & Behavioral Psychologist 103TB0200X PY8941 FL
Clinical Psychologist 103TC0700X PY8941 FL Primary
Counseling Psychologist 103TC1900X PY8941 FL

Addresses

Primary practice location

310 S. Dillard Street
Suite 190
Winter Garden, FL 34787

Mailing address

310 S. Dillard Street
Suite 190
Winter Garden, FL 34787
Phone (407) 347-0661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140424002088 FL Practitioner - Clinical Psychologist 8820221922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

310 S Dillard St
Winter Garden, FL 34787-3567
Phone (407) 347-0661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY8941FLMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling & Psychological Services of Central Florida, LLC CurrentSince Sep 5, 2015 Accepting new patients

Locations

310 S Dillard St
Ste 190
Winter Garden, FL 34787
Phone (407) 347-0661

310 S Dillard St
Winter Garden, FL 34787

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1417378910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S. DILLARD STREET",
            "address_2": "SUITE 190",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "34787",
            "telephone_number": "407-347-0661",
            "fax_number": "407-347-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S. DILLARD STREET",
            "address_2": "SUITE 190",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "34787",
            "telephone_number": "407-347-0661",
            "fax_number": "407-347-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTT",
        "first_name": "PARKER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-30",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8941",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY8941",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8941",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY8941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.