Active NPI
Dennis Neil Profitt, PH.D.
- Counseling Psychologist
- Pensacola, FL
National Provider Identifier
1558258756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 20041991A
- Practice address
- 110 Raby Ave
Pensacola, FL 32509-5124 - Phone
- (850) 457-1911
- NPI assigned
- Jun 20, 2025
- Last updated
- Jun 20, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 20041991A | IN | MD | Counseling 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": []
}
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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.