Individual provider Active NPI

Robyn Carroll-Yenko, M.S., NCSP

  • School Psychologist
  • Rockledge, FL
National Provider Identifier
1669832937
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
SS1222 Issued in FL
Practice address
107 Oakledge Dr
Rockledge, FL 32955-5612
Phone
(407) 412-4105
NPI assigned
Mar 1, 2016
Reactivated
Jan 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X SS1222 FL Primary

Addresses

Primary practice location

107 Oakledge Dr
Rockledge, FL 32955-5612

Mailing address

PO Box 561348
Rockledge, FL 32956
Phone (407) 412-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SS1222FLMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1669832937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 561348",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32956",
            "telephone_number": "407-412-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 OAKLEDGE DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329555612",
            "telephone_number": "407-412-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL-YENKO",
        "first_name": "ROBYN",
        "credential": "M.S., NCSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "deactivation_date": "2017-06-08",
        "reactivation_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS1222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.