Psych-MD, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PSYCH-MD, LLC

Practice address

11924 NW 12TH St
Pembroke Pines, FL 33026-3856

Phone

(786) 785-0585

NPI assigned

Apr 11, 2019

Last updated

Jun 11, 2019By 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

Oluleye Adigun, MCAPNPI 1255843652

Title

Ceo

Phone

(786) 785-0585

Specialties & licenses 2

Addresses

Other identifiers 2

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.

• Oluleye Adigun, MA, MCAP, PHD CANDID

  • Community Health Clinic/Center
  • North Miami Beach, FL
  • NPI 1255843652

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1558824003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11924 NW 12TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263856",
            "telephone_number": "786-785-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11924 NW 12TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263856",
            "telephone_number": "786-785-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCH-MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "ADIGUN",
        "authorized_official_first_name": "OLULEYE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-785-0585",
        "authorized_official_credential": "MCAP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1255843652",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255843652",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Pryor, ARNP
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• Community/Behavioral Health Agency in Pembroke Pines, FL
• Providers in Pembroke Pines, 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 Jun 11, 2019; 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.