Individual provider Active NPI

Michael George Foertsch, PSYD

  • Counselor
  • Fort Lauderdale, FL
National Provider Identifier
1629165311
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
3300 Port Royale Dr N
Apartment 117
Fort Lauderdale, FL 33308-7919
Phone
(443) 910-8204
NPI assigned
Oct 6, 2006
Last updated
Feb 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

3300 Port Royale Dr N
Apartment 117
Fort Lauderdale, FL 33308-7919

Mailing address

3300 N Port Royale Dr
Apartment 117
Fort Lauderdale, FL 33308-7919
Phone (443) 910-8204

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Clinical & Forensic Psychology Inc PastSince Sep 10, 2004 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1629165311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N PORT ROYALE DR",
            "address_2": "APARTMENT 117",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333087919",
            "telephone_number": "443-910-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 PORT ROYALE DR N",
            "address_2": "APARTMENT 117",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333087919",
            "telephone_number": "443-910-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOERTSCH",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.