Individual provider Active NPI

Karlin Antoinette Donegal, PH.D.

  • Clinical Psychologist
  • Tamarac, FL
National Provider Identifier
1770670549
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6151 Issued in FL
Practice address
7051 W. Commercial Blvd
Suite #3a
Tamarac, FL 33319-2146
Phone
(954) 720-0412
Fax
(954) 720-0824
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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 PY6151 FL Primary

Addresses

Primary practice location

7051 W. Commercial Blvd
Suite #3a
Tamarac, FL 33319-2146

Mailing address

6610 N University Dr
Ste 220
Tamarac, FL 33321-4000
Phone (954) 720-0412

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
I20090226000220 FL Practitioner - Clinical Psychologist 8224194303 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bird of Paradise Psychological Services PA Clinical CurrentSince May 18, 2000 Accepting new patients

Locations

4300 N University Dr
Ste C203
Lauderhill, FL 33351
Phone (954) 742-5800

7051 W Commercial Blvd
Ste 3A
Lauderhill, FL 33319
Phone (954) 720-0412

6635 W Commercial Blvd
Ste 117
Tamarac, FL 33319
Phone (954) 522-3360

6610 N University Dr
Ste 220
Tamarac, FL 33321
Phone (954) 720-0412

7301 N University Dr
Ste 201
Tamarac, FL 33321
Phone (954) 720-0412

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1770670549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6610 N UNIVERSITY DR",
            "address_2": "STE 220",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333214000",
            "telephone_number": "954-720-0412",
            "fax_number": "954-720-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7051 W. COMMERCIAL BLVD",
            "address_2": "SUITE #3A",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192146",
            "telephone_number": "954-720-0412",
            "fax_number": "954-720-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONEGAL",
        "first_name": "KARLIN",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

Verify at the official NPI Registry.