Stacy Sanders Shaup, PHD, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 7280 Issued in FL

Legal business name

STACY SANDERS SHAUP, PHD, PLLC

Practice address

10100 W Sample Rd
Suite 331
Coral Springs, FL 33065-3973

Phone

(954) 752-9353

Fax

(954) 752-9353

NPI assigned

Oct 17, 2014

Last updated

Jun 7, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stacy Shaup, PHDNPI 1144277617

Title

MGRM

Phone

(954) 752-9353

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Stacy Sanders Shaup, PH.D.

  • Psychologist
  • Coral Springs, FL
  • NPI 1144277617
  Authorized official Same address or phone

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1649674805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 W SAMPLE RD",
            "address_2": "SUITE 331",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653973",
            "telephone_number": "954-752-9353",
            "fax_number": "954-752-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 W SAMPLE RD",
            "address_2": "SUITE 331",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653973",
            "telephone_number": "954-752-9353",
            "fax_number": "954-752-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY SANDERS SHAUP, PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "SHAUP",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "MGRM",
        "authorized_official_telephone_number": "954-752-9353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pierre Jerry St Gelus, PMHNP-BC
• Anderston St Germain, OT
• Francesca Alexis St Pierre, FNP
• Nestor Dominic St. Charles, L.M.H.C.
• Stacie Ginsberg DO PA
• Stacy Sarnoff, LCSW, PA
• Julia Marie Staddon, PA
• Meghann Stamper, MA CCC-SLP
• Faith Stample, LPN
• Amy Stark, MS, OTR/L, CHT

• Clinical Psychologist in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.