Active NPI
Katrina Verdon, PSY. D.
- Clinical Psychologist
- Fort Lauderdale, FL
National Provider Identifier
1588325856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY11271
- Practice address
- 511 SE 5TH Ave Apt 720
Fort Lauderdale, FL 33301-2968 - Phone
- (607) 765-1378
- NPI assigned
- Jan 7, 2022
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY11271 | FL | Primary |
Addresses
Primary practice location
511 SE 5TH Ave Apt 720
Fort Lauderdale, FL 33301-2968
Mailing address
511 SE 5TH Ave Apt 720
Fort Lauderdale, FL 33301-2968
Phone (607) 765-1378
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 |
|---|---|---|---|
| PY11271 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1588325856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 SE 5TH AVE APT 720",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333012968",
"telephone_number": "607-765-1378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 SE 5TH AVE APT 720",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333012968",
"telephone_number": "607-765-1378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERDON",
"first_name": "KATRINA",
"name_prefix": "Dr.",
"credential": "PSY. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-07",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY11271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.