NPIMap

Organization Active NPI

Psychotherapeutic Services of Florida, in

  • Psychiatry Physician
  • Fort Pierce, FL
National Provider Identifier
1508432295
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHOTHERAPEUTIC SERVICES OF FLORIDA, IN
Practice address
4152 Okeechobee Rd Ste C
Fort Pierce, FL 34947-5402
Phone
(772) 467-3097
NPI assigned
Jun 2, 2021
Last updated
Jun 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Randall Cooper
Title
Chief Financial Officer
Phone
(410) 810-2468

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X NU
Social Worker 104100000X NU
Registered Nurse 163W00000X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

4152 Okeechobee Rd Ste C
Fort Pierce, FL 34947-5402

Mailing address

870 High St Ste 2
Chestertown, MD 21620-3914
Phone (410) 788-1099

National Provider Directory

National Provider Directory
Tax ID family
Psi Acist Program44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

4152 Okeechobee Rd
Ste C
Fort Pierce, FL 34947
Phone (772) 467-3097

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1508432295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 HIGH ST STE 2",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216203914",
            "telephone_number": "410-788-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4152 OKEECHOBEE RD STE C",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349475402",
            "telephone_number": "772-467-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOTHERAPEUTIC SERVICES OF FLORIDA, IN",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "410-810-2468"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.