Organization Active NPI

Crutchfield Psychology Inc

  • Counseling Psychologist
  • Dunedin, FL
National Provider Identifier
1447867361
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
CRUTCHFIELD PSYCHOLOGY INC
Practice address
1613 Main St
Dunedin, FL 34698-4759
Phone
(727) 736-3132
Fax
(727) 472-0338
NPI assigned
Sep 24, 2020
Last updated
Sep 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Authorized official

Name
Dr. Gloria P Crutchfield, PHDNPI 1518073188
Title
President
Phone
(727) 656-5753

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X NU Primary

Addresses

Primary practice location

1613 Main St
Dunedin, FL 34698-4759

Mailing address

PO Box 1465
Safety Harbor, FL 34695-1465
Phone (727) 458-3014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201105001195 FL Part B Supplier - Clinic/Group Practice 7214347061 Receives reassigned benefits from 1 practitioner
Practice locations: Dunedin, FL

National Provider Directory

National Provider Directory

Locations

126 3rd Ave N
Ste 103
Safety Harbor, FL 34695

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": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1447867361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1465",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346951465",
            "telephone_number": "727-458-3014",
            "fax_number": "727-472-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 MAIN ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346984759",
            "telephone_number": "727-736-3132",
            "fax_number": "727-472-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRUTCHFIELD PSYCHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "CRUTCHFIELD",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-656-5753",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.