Premier Psychological Services, PL

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY7877 Issued in FL

Legal business name

PREMIER PSYCHOLOGICAL SERVICES, PL

Practice address

324 W Bearss Ave Ste B
Tampa, FL 33613-1228

Phone

(888) 899-7736

NPI assigned

Aug 18, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Brad PalermoNPI 1558567602

Title

Licensed Psychologist, Member

Phone

(888) 899-7736

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brad Palermo, PSY.D., LICENSED PSY

  • Clinical Psychologist
  • Tampa, FL
  • NPI 1558567602
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1467767178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 W BEARSS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131228",
            "telephone_number": "888-899-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W BEARSS AVE STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131228",
            "telephone_number": "888-899-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PSYCHOLOGICAL SERVICES, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-18",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "PALERMO",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST, MEMBER",
        "authorized_official_telephone_number": "888-899-7736",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7877",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "PY7877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.