NPIMap

Organization Active NPI

Development Learning Center of St Lucie County Florida Inc

  • Psychologist
  • Port St Lucie, FL
National Provider Identifier
1710253943
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY5121 Issued in FL
Legal business name
DEVELOPMENT LEARNING CENTER OF ST LUCIE COUNTY FLORIDA INC
Practice address
2550 SE Walton Rd
Port St Lucie, FL 34952-7168
Phone
(772) 979-5515
Fax
(772) 335-5855
NPI assigned
Apr 2, 2012
Last updated
Dec 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Dr. John Eugene Mauldin, PHD
Title
President
Phone
(772) 871-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY5121 FL Primary

Addresses

Primary practice location

2550 SE Walton Rd
Port St Lucie, FL 34952-7168

Mailing address

2423 Tamarind Dr
Fort Pierce, FL 34949-1544
Phone (772) 979-5515

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1710253943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 TAMARIND DR",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349491544",
            "telephone_number": "772-979-5515",
            "fax_number": "772-335-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 SE WALTON RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527168",
            "telephone_number": "772-979-5515",
            "fax_number": "772-335-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENT LEARNING CENTER OF ST LUCIE COUNTY FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "MAULDIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-871-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.