NPIMap

Organization Active NPI

Psychology Center for Wellness LLC

  • Psychologist
  • Tampa, FL
National Provider Identifier
1639325186
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY6542 Issued in FL
Legal business name
PSYCHOLOGY CENTER FOR WELLNESS LLC
Practice address
308 E Oak Ave
Tampa, FL 33602-2344
Phone
(813) 810-8110
Fax
(813) 225-5678
NPI assigned
Aug 15, 2008
Last updated
Aug 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Authorized official

Name
Robert J Porter, PHD
Title
President
Phone
(813) 810-8110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY6542 FL Primary

Addresses

Primary practice location

308 E Oak Ave
Tampa, FL 33602-2344

Mailing address

308 E Oak Ave
Tampa, FL 33602-2344
Phone (813) 810-8110

Other identifiers 1

IdentifierTypeStateIssuer
54803OtherFLBSFL

National Provider Directory

National Provider Directory

Locations

308 E Oak Ave
Tampa, FL 33602
Phone (813) 810-8110

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1639325186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E OAK AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336022344",
            "telephone_number": "813-810-8110",
            "fax_number": "813-225-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E OAK AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336022344",
            "telephone_number": "813-810-8110",
            "fax_number": "813-225-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY CENTER FOR WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-810-8110",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSFL",
            "identifier": "54803",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.