Individual provider Active NPI

Dean Russell Cauley, PH.D.

  • Mental Health Counselor
  • Port Charlotte, FL
National Provider Identifier
1487858437
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH7104 Issued in FL
Practice address
2765 Tamiami TRL Ste C
Port Charlotte, FL 33952-5163
Phone
(941) 661-8895
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH7104 FL Primary

Addresses

Primary practice location

2765 Tamiami TRL Ste C
Port Charlotte, FL 33952-5163

Mailing address

3270 Yukon Dr
Port Charlotte, FL 33948-6130
Phone (941) 627-2867

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH7104FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487858437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 YUKON DR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339486130",
            "telephone_number": "941-627-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 TAMIAMI TRL STE C",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525163",
            "telephone_number": "941-661-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAULEY",
        "first_name": "DEAN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.