Individual provider Active NPI

Marianne L McCain, PH.D.

  • Clinical Psychologist
  • Ft Walton Beach, FL
National Provider Identifier
1699749846
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0004162 Issued in FL
Practice address
348 Miracle Strip Pkwy SW
Suite 32a
Ft Walton Beach, FL 32548-5200
Phone
(850) 664-7690
Fax
(850) 664-7691
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0004162 FL Primary

Addresses

Primary practice location

348 Miracle Strip Pkwy SW
Suite 32a
Ft Walton Beach, FL 32548-5200

Mailing address

348 Miracle Strip Pkwy SW
Suite 32a
Ft Walton Beach, FL 32548-5200
Phone (850) 664-7690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080417000489 FL Practitioner - Clinical Psychologist 7315025244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

118 Truxton Ave
Fort Walton Beach, FL 32547-2461
Phone (850) 664-7690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY0004162FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Marianne L McCain PH D P a Clinical CurrentSince Mar 10, 2008 Accepting new patients

Locations

118 Truxton Ave
Fort Walton Beach, FL 32547
Phone (850) 664-7690

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699749846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW",
            "address_2": "SUITE 32A",
            "city": "FT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485200",
            "telephone_number": "850-664-7690",
            "fax_number": "850-664-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW",
            "address_2": "SUITE 32A",
            "city": "FT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485200",
            "telephone_number": "850-664-7690",
            "fax_number": "850-664-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAIN",
        "first_name": "MARIANNE",
        "middle_name": "L",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0004162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.