Individual provider Active NPI

Melissa Marie Bahamonde, PHD

  • School Psychologist
  • Zephyrhills, FL
National Provider Identifier
1508603424
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
SS1444 Issued in FL
Practice address
6272 Abbott Station Dr Ste D
Zephyrhills, FL 33542-4877
Phone
(352) 727-8968
NPI assigned
Jul 9, 2024
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X SS1444 FL Primary

Addresses

Primary practice location

6272 Abbott Station Dr Ste D
Zephyrhills, FL 33542-4877

Mailing address

7116 Redroot CT
Wesley Chapel, FL 33545-5068
Phone (352) 727-8968

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
SS1444FLMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1508603424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7116 REDROOT CT",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335455068",
            "telephone_number": "352-727-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6272 ABBOTT STATION DR STE D",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335424877",
            "telephone_number": "352-727-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHAMONDE",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS1444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.