A Peaceful Mind Behavior Services

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Legal business name

A PEACEFUL MIND BEHAVIOR SERVICES

Practice address

12381 S Cleveland Ave Ste 403
Fort Myers, FL 33907-3853

Phone

(239) 266-2620

NPI assigned

Jul 9, 2024

Last updated

Jul 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michele Renzulli, PHD

Title

Business Manager/Point of Contact

Phone

(239) 533-9604

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1467299453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12381 S CLEVELAND AVE STE 403",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12381 S CLEVELAND AVE STE 403",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073853",
            "telephone_number": "239-266-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A PEACEFUL MIND BEHAVIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "RENZULLI",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "BUSINESS MANAGER/POINT OF CONTACT",
        "authorized_official_telephone_number": "239-533-9604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.