NPIMap

Organization Active NPI

Progressive Psychological Services

  • Clinical Psychologist
  • Ormond Beach, FL
National Provider Identifier
1568949865
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY10079 Issued in FL
Legal business name
PROGRESSIVE PSYCHOLOGICAL SERVICES
Practice address
137 Mill Spring PL
Ormond Beach, FL 32174-4820
Phone
(773) 733-6629
Fax
(386) 463-2170
NPI assigned
Jul 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Dr. Laurie Ann Deckard-Tankersley, PSY.D.NPI 1083659445
Title
Managing Partner/Owner
Phone
(773) 733-6629

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY10079 FL Primary

Addresses

Primary practice location

137 Mill Spring PL
Ormond Beach, FL 32174-4820

Mailing address

137 Mill Spring PL
Ormond Beach, FL 32174-4820
Phone (177) 373-3662

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1568949865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 MILL SPRING PL",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321744820",
            "telephone_number": "177-373-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 MILL SPRING PL",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321744820",
            "telephone_number": "773-733-6629",
            "fax_number": "386-463-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "DECKARD-TANKERSLEY",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGING PARTNER/OWNER",
        "authorized_official_telephone_number": "773-733-6629",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.