Adam Castleberry, PSY.D
Individual provider Active NPI Clinical Psychologist · Lake Park, GA
NPI 1689950693 · NPPES record last updated May 19, 2020
Key facts
- NPI
- 1689950693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY003724 (GA)
- Practice address
- 1013 Egret Way
Lake Park, GA 31636-2759 - Phone
- (292) 588-1985
- NPI assigned
- Oct 24, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Christopher Dennis MD PLLC
Che Behavioral Health Services of Florida, P.a.
Practice addresses (Care Compare)
1420 Milstead Rd NE
Conyers, GA 30012-3823
Phone (888) 515-3834
6750 N Andrews Ave
Suite 200
Ft Lauderdale, FL 33309-2180
Phone (888) 515-3834
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121114000434 | FL | Practitioner - Clinical Psychologist | 2062686892 | Reassigns benefits to 1 organization |
| I20131204001623 | GA | Practitioner - Clinical Psychologist | 2062686892 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christopher Dennis MD PLLC | Clinical | Current |
Accepting new patients |
| Che Behavioral Health Services of Florida, P.a. | Clinical | Current |
Accepting new patients |
Locations
6750 N Andrews Ave
Ste 200
Lauderdale Lakes, FL 33309
Phone (718) 408-5477
1420 Milstead Rd NE
Conyers, GA 30012
Phone (770) 483-3902
11340 Lakefield Dr
Ste 200
Johns Creek, GA 30097
Phone (678) 407-2159
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY003724 | GA | Yes |
| Clinical Psychologist | 103TC0700X | 8652 | FL |
Addresses
Primary practice location
1013 Egret Way
Lake Park, GA 31636-2759
Mailing address
20 Research Pkwy
Old Saybrook, CT 06475-4214
Phone (800) 370-3651
Other providers in Lake Park, GA
- Adam Amar
- Vanessa Y Baker
- Franklin Dewayne Brown
- Edwin Carter Jr.
- Century Transport LLC
- Ursula Lori Clark
- Lauren Osborne Courson Bibin
- Devyn Kangas Physical Therapy LLC
- Wendy Ann Dorminey
All providers in Lake Park, GA · Clinical Psychologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.