Organization Active NPI

Harald W Lettner PHD PA

  • Clinical Neuropsychologist
  • Naples, FL
National Provider Identifier
1508950312
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY4878 Issued in FL
Legal business name
HARALD W LETTNER PHD PA
Practice address
501 Goodlette Rd N
Ste. C 104
Naples, FL 34102-5661
Phone
(239) 434-6111
Fax
(239) 649-0472
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Authorized official

Name
Dr. Harald Wolfgang Lettner, PHD
Title
Owner
Phone
(239) 434-6111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X PY4878 FL Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PY4878 FL

Addresses

Primary practice location

501 Goodlette Rd N
Ste. C 104
Naples, FL 34102-5661

Mailing address

501 Goodlette Rd N
Ste. C 104
Naples, FL 34102-5661
Phone (239) 434-6111

Other identifiers 2

IdentifierTypeStateIssuer
59545OtherFLBLUE CROSS BLUE SHIELD ID
PY4878OtherFLLICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

501 Goodlette Rd
Ste D306
Naples, FL 34102
Phone (239) 263-0014

501 Goodlette Rd
Ste C104
Naples, FL 34102
Phone (238) 434-6111

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1508950312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOODLETTE RD N",
            "address_2": "STE. C 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025661",
            "telephone_number": "239-434-6111",
            "fax_number": "239-649-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOODLETTE RD N",
            "address_2": "STE. C 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025661",
            "telephone_number": "239-434-6111",
            "fax_number": "239-649-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARALD W LETTNER PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "LETTNER",
        "authorized_official_first_name": "HARALD",
        "authorized_official_middle_name": "WOLFGANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-434-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY4878",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4878",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "59545",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PY4878",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.