Active NPI
Daniel Lee Paulson, PHD
- Clinical Psychologist
- Casselberry, FL
National Provider Identifier
1659883239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY9598
- Practice address
- 1254 Grantham CT
Casselberry, FL 32707-5807 - Phone
- (540) 746-3806
- NPI assigned
- Nov 3, 2017
- Sex
- Male
- 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 | PY9598 | FL | Primary |
Addresses
Primary practice location
1254 Grantham CT
Casselberry, FL 32707-5807
Mailing address
341 N Maitland Ave
Ste 120
Maitland, FL 32751-4761
Phone (407) 756-2084
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
341 N Maitland Ave
Suite 120
Maitland, FL 32751-4761
Phone (407) 756-2084
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Live Oak Behavioral Health PA | Current | Accepting new patients |
Locations
341 N Maitland Ave
Ste 120
Maitland, FL 32751
Phone (407) 756-2084
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.
-
- Cognitive & Behavioral Psychologist
- Maitland, FL
- NPI 1508368192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614211200000",
"number": "1659883239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "341 N MAITLAND AVE",
"address_2": "STE 120",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327514761",
"telephone_number": "407-756-2084",
"fax_number": "866-495-9224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1254 GRANTHAM CT",
"city": "CASSELBERRY",
"state": "FL",
"postal_code": "327075807",
"telephone_number": "540-746-3806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULSON",
"first_name": "DANIEL",
"middle_name": "LEE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-03",
"last_updated": "2021-02-25",
"certification_date": "2021-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY9598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casselberry, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.