Individual provider Active NPI

Pearlene S. Gardberg-Deluca, PSYD

  • Counseling Psychologist
  • Altamonte Springs, FL
National Provider Identifier
1720199300
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PY0004744 Issued in FL
Practice address
378 Center Pointe Circle
Suite 1280
Altamonte Springs, FL 32701-3442
Phone
(407) 862-5959
Fax
(407) 774-5573
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PY0004744 FL Primary

Addresses

Primary practice location

378 Center Pointe Circle
Suite 1280
Altamonte Springs, FL 32701-3442

Mailing address

378 Center Pointe Circle
Suite 1280
Altamonte Springs, FL 32701-3442
Phone (407) 862-5959

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY0004744FLMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph N Deluca, PHD, PA Counseling PastSince Jun 1, 2010 Accepting new patients

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1720199300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 CENTER POINTE CIRCLE",
            "address_2": "SUITE 1280",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327013442",
            "telephone_number": "407-862-5959",
            "fax_number": "407-774-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 CENTER POINTE CIRCLE",
            "address_2": "SUITE 1280",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327013442",
            "telephone_number": "407-862-5959",
            "fax_number": "407-774-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDBERG-DELUCA",
        "first_name": "PEARLENE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY0004744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.