Organization Active NPI

Jill a. Selbach, PH.D., P.a.

  • Psychologist
  • Lighthouse Point, FL
National Provider Identifier
1598033573
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY6375 Issued in FL
Legal business name
JILL A. SELBACH, PH.D., P.A.
Practice address
3650 N Federal Hwy
215
Lighthouse Point, FL 33064-6649
Phone
(954) 618-8412
Fax
(954) 782-8389
NPI assigned
Dec 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Authorized official

Name
Dr. Jill Ann Selbach, PH.D.
Title
Clinical Psychologist
Phone
(954) 618-8412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY6375 FL Primary

Addresses

Primary practice location

3650 N Federal Hwy
215
Lighthouse Point, FL 33064-6649

Mailing address

3650 N Federal Hwy
215
Lighthouse Point, FL 33064-6649
Phone (954) 618-8412

National Provider Directory

National Provider Directory

Locations

2211 NE 36th St
Ste 202
Lighthouse Point, FL 33064
Phone (954) 614-3414

3650 N Federal Hwy
Ste 215
Lighthouse Point, FL 33064
Phone (954) 618-8412

2211 NE 36th St
Ste 205
Lighthouse Point, FL 33064
Phone (954) 618-8412

Practitioners & affiliated clinicians

Practitioners 2

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": "1323129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1598033573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 N FEDERAL HWY",
            "address_2": "215",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330646649",
            "telephone_number": "954-618-8412",
            "fax_number": "954-782-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 N FEDERAL HWY",
            "address_2": "215",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330646649",
            "telephone_number": "954-618-8412",
            "fax_number": "954-782-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL A. SELBACH, PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "SELBACH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "954-618-8412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lighthouse Point, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.