NPIMap

Organization Active NPI

Marcus Psychology, Inc.

  • Clinical Psychologist
  • Miami, FL
National Provider Identifier
1669517462
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7161 Issued in FL
Legal business name
MARCUS PSYCHOLOGY, INC.
Practice address
7685 SW 104TH St
Suite 100
Miami, FL 33156-3161
Phone
(305) 666-8000
Fax
(305) 666-4311
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nicole Eldridge Marcus, PH.D.
Title
Director, Licensed Psychologist
Phone
(305) 666-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY7161 FL Primary

Addresses

Primary practice location

7685 SW 104TH St
Suite 100
Miami, FL 33156-3161

Mailing address

7685 SW 104TH St
Suite 100
Miami, FL 33156-3161
Phone (305) 666-8000

Other identifiers 1

IdentifierTypeStateIssuer
75024OtherFLBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669517462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7685 SW 104TH ST",
            "address_2": "SUITE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331563161",
            "telephone_number": "305-666-8000",
            "fax_number": "305-666-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7685 SW 104TH ST",
            "address_2": "SUITE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331563161",
            "telephone_number": "305-666-8000",
            "fax_number": "305-666-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCUS PSYCHOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARCUS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ELDRIDGE",
        "authorized_official_title_or_position": "DIRECTOR, LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "305-666-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "75024",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.