Active NPI
Karina Petryshova, PSYD
- Clinical Psychologist
- Tallahassee, FL
National Provider Identifier
1619454279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY13260
- Practice address
- 1616 Physicians Dr
Tallahassee, FL 32308-4619 - Phone
- (510) 841-1262
- NPI assigned
- Jul 25, 2018
- Last updated
- Aug 26, 2026
- 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 | PY13260 | FL | Primary |
Addresses
Primary practice location
1616 Physicians Dr
Tallahassee, FL 32308-4619
Mailing address
1616 Physicians Dr
Tallahassee, FL 32308-4619
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1619454279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 PHYSICIANS DR",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 PHYSICIANS DR",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084619",
"telephone_number": "510-841-1262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRYSHOVA",
"first_name": "KARINA",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-25",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY13260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.