Individual provider Active NPI

Sheriece Sadberry, PH.D., LP, CMPC

  • Counseling Psychologist
  • Tampa, FL
National Provider Identifier
1639424930
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
8416 Issued in FL
Practice address
7819 N Dale Mabry Hwy Ste 108
Tampa, FL 33614-3210
Phone
(813) 538-0149
Fax
(844) 371-0868
NPI assigned
Jul 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 2029 KS
Exercise & Sports Psychologist 103TE1100X 8416 FL
Exercise & Sports Psychologist 103TE1100X 2029 KS
Counseling Psychologist 103TC1900X 8416 FL Primary

Addresses

Primary practice location

7819 N Dale Mabry Hwy Ste 108
Tampa, FL 33614-3210

Mailing address

7819 N Dale Mabry Hwy Ste 108
Tampa, FL 33614-3210
Phone (813) 538-0149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926000088 FL Practitioner - Clinical Psychologist 0840573564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Moments, LLCGroup PAC ID 9931482650, 4 clinicians

Practice addresses (Care Compare)

7819 N Dale Mabry Hwy
Suite 108
Tampa, FL 33614-3210
Phone (813) 538-0149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8416FLMDExercise & Sports Psychologist
2029KSMDOptometrist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1639424930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7819 N DALE MABRY HWY STE 108",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143210",
            "telephone_number": "813-538-0149",
            "fax_number": "844-371-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7819 N DALE MABRY HWY STE 108",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143210",
            "telephone_number": "813-538-0149",
            "fax_number": "844-371-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADBERRY",
        "first_name": "SHERIECE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP, CMPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "KS",
            "license": "2029",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "FL",
            "license": "8416",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "KS",
            "license": "2029",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "8416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.