Trauma Recovery Group

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

TRAUMA RECOVERY GROUP

Practice address

9887 4TH St N Ste 319
St Petersburg, FL 33702-8445

Phone

(727) 379-2804

NPI assigned

Mar 27, 2021

Last updated

Apr 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samantha L Brustad, PSY.DNPI 1013554435

Title

Owner/Psy.D

Phone

(727) 379-2804

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, and the practitioner matching its NPPES authorized official.

• Samantha Brustad, PSY.D

  • Clinical Psychologist
  • St Petersburg, FL
  • NPI 1013554435
  Authorized official Same address or phone

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1538746227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9887 4TH ST N STE 319",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337028445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9887 4TH ST N STE 319",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337028445",
            "telephone_number": "727-379-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA RECOVERY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-27",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "BRUSTAD",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PSY.D",
        "authorized_official_telephone_number": "727-379-2804",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Trauma and Transition Services LLC
• Catherine Travelute, PH. D.
• Daniel Raymond Traver, DNP
• Rita Traver
• Gloria E Travieso-Zadan, MD
• Nicholas Richard Travis, FNP

• Clinical Psychologist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.