Dr Terri Mortensen

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PY7594 Issued in FL

Legal business name

DR TERRI MORTENSEN

Practice address

4900 S University Dr
Ste 200 D
Davie, FL 33328-3808

Phone

(954) 417-6545

NPI assigned

Dec 28, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Terri MortensenNPI 1336328343

Title

Owner

Phone

(954) 417-6545

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Terri Kay Mortensen

  • Clinical Child & Adolescent Psychologist
  • Davie, FL
  • NPI 1336328343
  NPD (past) Authorized official

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1538604681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S UNIVERSITY DR",
            "address_2": "STE 200 D",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333283808",
            "telephone_number": "954-417-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 S UNIVERSITY DR",
            "address_2": "STE 200 D",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333283808",
            "telephone_number": "954-417-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TERRI MORTENSEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-28",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "MORTENSEN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-417-6545",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "PY7594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Davie, FL
• Providers in Davie, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.