Broward Psychological Group Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY002243 Issued in FL

Legal business name

BROWARD PSYCHOLOGICAL GROUP INC

Practice address

4400 Sheridan St
Hollywood, FL 33021-3514

Phone

(954) 961-5447

NPI assigned

Nov 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Warren Byron Graditor, PH.D.

Title

President

Phone

(954) 961-5447

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1467607960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213514",
            "telephone_number": "954-961-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213514",
            "telephone_number": "954-961-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD PSYCHOLOGICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-25",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "GRADITOR",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "BYRON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-961-5447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY002243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.