Active NPI
Brooke Lyall Foris, PSY.D.
- Psychologist
- Fort Myers, FL
National Provider Identifier
1558653071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 8274
- Practice address
- 15101 6 Mile Cypress Parkway
Suite 115
Fort Myers, FL 33966 - Phone
- (239) 790-6614
- Fax
- (239) 344-7635
- NPI assigned
- May 3, 2011
- Last updated
- Dec 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 8274 | FL | Primary |
Addresses
Primary practice location
15101 6 Mile Cypress Parkway
Suite 115
Fort Myers, FL 33966
Mailing address
13650 Fiddlesticks Blvd.
Suite 202-104
Fort Myers, FL 33912
Phone (239) 790-6614
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8274 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702425600000",
"number": "1558653071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13650 FIDDLESTICKS BLVD.",
"address_2": "SUITE 202-104",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33912",
"telephone_number": "239-790-6614",
"fax_number": "239-344-7635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15101 6 MILE CYPRESS PARKWAY",
"address_2": "SUITE 115",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33966",
"telephone_number": "239-790-6614",
"fax_number": "239-344-7635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORIS",
"first_name": "BROOKE",
"middle_name": "LYALL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-03",
"last_updated": "2023-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "8274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
- Lawrence Harrison Force II
- Jared T Ford, D.D.S.
- John Edwin Ford Jr., RPH
- Christine Arminda Fordham, M.D.
- Fiorella Forgey
- Ivian Forjans Perez
- Jacquelyn Rae Forsythe, ARNP
- Fort Myers Central Chiropractic LLC
- Fort Myers Centre for Facial Plastic and Laser Surgery, Inc.
- Fort Myers Children's Surgery Center, LLC (Southwest Florida Institute of Ambulatory Surgery Inc)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.