Active NPI
Stacey Polott
- Clinical Psychologist
- Daytona Beach, FL
National Provider Identifier
1598156028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 9228
- Practice address
- 1821 Business Park Blvd
Daytona Beach, FL 32114-1230 - Phone
- (386) 366-6700
- Fax
- (386) 366-6790
- NPI assigned
- Feb 5, 2015
- Last updated
- Feb 5, 2015
- Sex
- Female
- Sole proprietor
- No
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 | PY 9228 | FL | Primary |
Addresses
Primary practice location
1821 Business Park Blvd
Daytona Beach, FL 32114-1230
Mailing address
1821 Business Park Blvd
Daytona Beach, FL 32114-1230
Phone (386) 366-6700
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 |
|---|---|---|---|
| PY 9228 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1598156028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1821 BUSINESS PARK BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321141230",
"telephone_number": "386-366-6700",
"fax_number": "386-366-6790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1821 BUSINESS PARK BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321141230",
"telephone_number": "386-366-6700",
"fax_number": "386-366-6790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLOTT",
"first_name": "STACEY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-05",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY 9228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daytona Beach, FL
- Loretta Ann Player, LMHC
- Lindsay Marie Podhajsky, M.D.
- Kaylee Alyse Poirier
- Apoorva Polavarapu
- Kenita Briana Polite, CNA
- Marygrace Polsinelli
- Eric B. Pontey, MD
- Jean Pierre Pontier, DMD MS
- Porter Chiropractic & Wellness, LLC (Porter Wellness & Integrative Medicine)
- Porter Chiropractic and Wellness, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.