Organization Active NPI

Creative Swim Therapy

  • Exercise & Sports Psychologist
  • Port Saint Lucie, FL
National Provider Identifier
1669123501
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exercise & Sports PsychologistTaxonomy code 103TE1100X
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

Updated by the provider on Jan 12, 2022

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)CodeLicenseStatePrimary
Exercise & Sports PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 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

TypeEndpointUseAffiliation
CONNECT URL creativeswimtherapy@gmail.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.