Individual provider Active NPI

Dennis Neil Profitt, PH.D.

  • Counseling Psychologist
  • Pensacola, FL
National Provider Identifier
1558258756
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
20041991A Issued in IN
Practice address
110 Raby Ave
Pensacola, FL 32509-5124
Phone
(850) 457-1911
NPI assigned
Jun 20, 2025
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 20041991A IN Primary

Addresses

Primary practice location

110 Raby Ave
Pensacola, FL 32509-5124

Mailing address

16251 Ygnacio Serra Dr
Pensacola, FL 32507-8365
Phone (812) 239-4643

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
20041991AINMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1558258756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16251 YGNACIO SERRA DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325078365",
            "telephone_number": "812-239-4643",
            "fax_number": "812-239-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 RABY AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325095124",
            "telephone_number": "850-457-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFITT",
        "first_name": "DENNIS",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20041991A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.