NPIMap

Individual provider Active NPI

Debra Lynn Stibick, PH.D.

  • Clinical Psychologist
  • Pinellas Park, FL
National Provider Identifier
1588641666
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY-9710 Issued in FL
Practice address
8130 66TH St N Ste 10
Pinellas Park, FL 33781-2111
Phone
(520) 490-2040
Fax
(727) 565-4188
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3689 AZ
Clinical Psychologist 103TC0700X PY-9710 FL Primary

Addresses

Primary practice location

8130 66TH St N Ste 10
Pinellas Park, FL 33781-2111

Mailing address

PO Box 3236
Seminole, FL 33775-3236
Phone (520) 490-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190318000703 FL Practitioner - Clinical Psychologist 4385649193 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CPF SJN Outpatient LLCGroup PAC ID 0749637163, 24 clinicians

Practice addresses (Care Compare)

2025 Indian Rocks Rd S
Largo, FL 33774-1035
Phone (713) 789-7560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY-9710FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Behavioral Health Inc. Current Accepting new patients
Behavioral Health Management Services Inc CurrentSince Dec 31, 2018 Accepting new patients
Winter Haven Hospital Inc CurrentSince Dec 31, 2018 Accepting new patients
Winter Haven Hospital Inc CurrentSince Dec 31, 2018 Accepting new patients
Behavioral Health Management Services, Inc. Current Accepting new patients
Baycare Behavioral Health Associates LLC CurrentSince Dec 31, 2018 Accepting new patients
Baycare Behavioral Health Associates LLC Clinical Current Accepting new patients
Baycare Behavioral Health, Inc CurrentSince Dec 31, 2018 Accepting new patients
Baycare Behavioral Health, Inc CurrentSince Dec 31, 2018 Accepting new patients
Behavioral Health Management Services, Inc. CurrentSince Dec 31, 2018 Accepting new patients
Debra Lynn Stibick, PH.D., LLC Clinical Past Accepting new patients

Locations

1106 Druid Rd S
Clearwater, FL 33756
Phone (727) 584-6266

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

7809 Massachusetts Ave
Ste 100
New Prt Rchy, FL 34653
Phone (727) 841-4200

6600 Madison St
New Pt Richey, FL 34652
Phone (727) 841-4611

1200 7th Ave N
St Petersburg, FL 33705
Phone (727) 820-7764

2727 W Mlk Blvd
Ste 640
Tampa, FL 33607
Phone (813) 842-7582

Interoperability endpoints

  • Direct secure messaging: debrastibickphd@direct.mybaycare.org

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1588641666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3236",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337753236",
            "telephone_number": "520-490-2040",
            "fax_number": "727-565-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 66TH ST N STE 10",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337812111",
            "telephone_number": "520-490-2040",
            "fax_number": "727-565-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIBICK",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3689",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY-9710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.