Active NPI
Creative Swim Therapy
- Exercise & Sports Psychologist
- Port Saint Lucie, FL
National Provider Identifier
1669123501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exercise & Sports Psychologist
- Legal business name
- CREATIVE SWIM THERAPY
- Practice address
- 307 SW Grimaldo Ter
Port Saint Lucie, FL 34984-4360 - Phone
- (772) 204-3977
- NPI assigned
- Jan 12, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sydney Belle
- Title
- Owner
- Phone
- (772) 204-3977
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exercise & Sports Psychologist | 103TE1100X | Primary |
Addresses
Primary practice location
307 SW Grimaldo Ter
Port Saint Lucie, FL 34984-4360
Mailing address
307 SW Grimaldo Ter
Port Saint Lucie, FL 34984-4360
Phone (772) 204-3977
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | creativeswimtherapy@gmail.com |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Exercise & Sports Psychologist
- Jensen Beach, FL
- NPI 1013796861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641945600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1641945600000",
"number": "1669123501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 SW GRIMALDO TER",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349844360",
"telephone_number": "772-204-3977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 SW GRIMALDO TER",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349844360",
"telephone_number": "772-204-3977"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CREATIVE SWIM THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-12",
"last_updated": "2022-01-12",
"certification_date": "2022-01-12",
"status": "A",
"authorized_official_last_name": "BELLE",
"authorized_official_first_name": "SYDNEY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "772-204-3977"
},
"taxonomies": [
{
"code": "103TE1100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Exercise & Sports",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "creativeswimtherapy@gmail.com",
"affiliation": "N",
"address_1": "307 SW Grimaldo Ter",
"city": "Port Saint Lucie",
"state": "FL",
"country_code": "US",
"postal_code": "349844360",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.