Organization Active NPI

Maria V. Nodarse, Psy. D., Inc

  • Psychologist
  • Mount Dora, FL
National Provider Identifier
1609405729
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MARIA V. NODARSE, PSY. D., INC
Practice address
1175 Lucerne Dr
Mount Dora, FL 32757-3639
Phone
(352) 630-0373
Fax
(352) 385-0128
NPI assigned
Apr 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Authorized official

Name
Dr. Maria V Nodarse, PSY.DNPI 1376811893
Title
Licensed Clinical Psychologist
Phone
(352) 630-0373

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
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

1175 Lucerne Dr
Mount Dora, FL 32757-3639

Mailing address

3279 Lakeshore Dr
Mount Dora, FL 32757-5410
Phone (352) 321-0098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200422003040 FL Part B Supplier - Clinic/Group Practice 2961832563 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Dora, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1585785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1609405729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3279 LAKESHORE DR",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327575410",
            "telephone_number": "352-321-0098",
            "fax_number": "352-385-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 LUCERNE DR",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327573639",
            "telephone_number": "352-630-0373",
            "fax_number": "352-385-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA V. NODARSE, PSY. D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-02",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "NODARSE",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "352-630-0373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.