NPIMap

Organization Active NPI

DMHG Psychological Services PLLC

  • Psychologist
  • Miramar, FL
National Provider Identifier
1447436340
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY 7636 Issued in FL
Legal business name
DMHG PSYCHOLOGICAL SERVICES PLLC
Practice address
4963 SW 128TH Ter
Miramar, FL 33027-5508
Phone
(305) 877-7051
NPI assigned
Jan 10, 2008
Last updated
Mar 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Authorized official

Name
Dr. Mary Denise Decruise, PSY.D
Title
MGMR/Owner
Phone
(305) 877-7051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY 7636 FL Primary

Addresses

Primary practice location

4963 SW 128TH Ter
Miramar, FL 33027-5508

Mailing address

4963 SW 128TH Ter
Miramar, FL 33027-5508
Phone (305) 877-7051

National Provider Directory

National Provider Directory

Locations

16969 NW 67th Ave
Ste 105
Miami Gardens, FL 33015
Phone (305) 819-4634

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1447436340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4963 SW 128TH TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330275508",
            "telephone_number": "305-877-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4963 SW 128TH TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330275508",
            "telephone_number": "305-877-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMHG PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "DECRUISE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "MGMR/OWNER",
        "authorized_official_telephone_number": "305-877-7051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 7636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.