Active NPI
Jennifer Smith Richards, PSYD
- Psychologist
- Port St Lucie, FL
National Provider Identifier
1477609303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 05973
- Practice address
- 2960 SE Santa Anita St.
Port St. Lucie, FL 34952 - Phone
- (203) 687-9007
- NPI assigned
- Jan 25, 2007
- Last updated
- May 25, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS017845 | PA | |
| Psychologist | 103T00000X | 05973 | MD | Primary |
| Clinical Psychologist | 103TC0700X | PS017845 | PA | |
| Clinical Psychologist | 103TC0700X | 12-031-PSY | VI | |
| Clinical Psychologist | 103TC0700X | 002758 | CT | |
| Clinical Psychologist | 103TC0700X | 05973 | MD |
Addresses
Primary practice location
2960 SE Santa Anita St.
Port St. Lucie, FL 34952
Mailing address
2960 SE Santa Anita St.
Port St. Lucie, FL 34952
Phone (203) 687-9007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS017845 | PA | MD | Psychologist |
| 12-031-PSY | VI | MD | Clinical Psychologist |
| 05973 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684972800000",
"number": "1477609303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2960 SE SANTA ANITA ST.",
"city": "PORT ST. LUCIE",
"state": "FL",
"postal_code": "34952",
"telephone_number": "203-687-9007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 SE SANTA ANITA ST.",
"city": "PORT ST. LUCIE",
"state": "FL",
"postal_code": "34952",
"telephone_number": "203-687-9007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "JENNIFER",
"middle_name": "SMITH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2023-05-25",
"certification_date": "2023-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS017845",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "05973",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017845",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VI",
"license": "12-031-PSY",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "002758",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "05973",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.