Active NPI
Channing Anne Sofko, PHD
- Clinical Psychologist
- Bay Pines, FL
National Provider Identifier
1427519610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS01739
- Practice address
- Bay Pines Vahcs
10000 Bay Pines Blvd
Bay Pines, FL 33744 - Phone
- (727) 398-6661
- NPI assigned
- Mar 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS01739 | RI | Primary |
Addresses
Primary practice location
Bay Pines Vahcs
10000 Bay Pines Blvd
Bay Pines, FL 33744
Mailing address
PO Box 5005
Bay Pines, FL 33744-5005
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS01739 | RI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557014400000",
"number": "1427519610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5005",
"city": "BAY PINES",
"state": "FL",
"postal_code": "337445005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BAY PINES VAHCS",
"address_2": "10000 BAY PINES BLVD",
"city": "BAY PINES",
"state": "FL",
"postal_code": "33744",
"telephone_number": "727-398-6661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOFKO",
"first_name": "CHANNING",
"middle_name": "ANNE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-29",
"last_updated": "2019-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS01739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.