Tina Dicicco Reynolds, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 7384 Issued in FL

Practice address

11401 NW 14TH CT
Pembroke Pines, FL 33026

Phone

(954) 787-9711

Fax

(954) 787-8116

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tina Dicicco Reynolds, PA

  • Clinical Psychologist
  • Pembroke Pines, FL
  • NPI 1336421718
  NPD Authorized official

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1508934928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 NW 14TH CT",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330262505",
            "telephone_number": "954-249-1871",
            "fax_number": "954-787-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 NW 14TH CT",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33026",
            "telephone_number": "954-787-9711",
            "fax_number": "954-787-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TINA",
        "middle_name": "DICICCO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-05-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY 7384",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY 7384",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "FL",
            "license": "PY 7384",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Reyes
• Roselynn Reyes, MS
• Yoaris Reyes
• Melanie Crystal Reynaga
• Patrick T. Reynolds, M.D.
• Vivian Rezende
• Rgpmd, LLC
• Rheumatology Center Inc
• Cynthia S. Rhodes, LCSW, RN, CAP, PHD
• Nicholas Ribbeck

• Clinical Psychologist in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.