Organization Active NPI

Lynn R Bernstein & Associates PA

  • Cognitive & Behavioral Psychologist
  • Englewood, FL
National Provider Identifier
1780742676
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
PY 3297 Issued in FL
Legal business name
LYNN R BERNSTEIN & ASSOCIATES PA
Practice address
1861 Placida Rd Ste 101
Englewood, FL 34223-4900
Phone
(941) 474-7170
Fax
(941) 475-2955
NPI assigned
Dec 5, 2006
Last updated
Aug 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Ms. Merri I Douthwright
Title
Admin Assistant
Phone
(941) 474-7170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X PY 3297 FL Primary

Addresses

Primary practice location

1861 Placida Rd Ste 101
Englewood, FL 34223-4900

Mailing address

1861 Placida Rd Ste 101
Englewood, FL 34223-4900
Phone (941) 474-7170

Other identifiers 1

IdentifierTypeStateIssuer
033111200MedicaidFL

Other names 1

  • ENGLEWOOD COUNSELING Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100311001067 FL Part B Supplier - Clinic/Group Practice 0143355487 Receives reassigned benefits from 2 practitioners
Practice locations: Englewood, FL; Nokomis, FL

National Provider Directory

National Provider Directory

Locations

1861 Placida Rd
Ste 101
Englewood, FL 34223
Phone (941) 258-6755

2504 Tamiami Trl N
Ste 1
Nokomis, FL 34275
Phone (941) 474-7170

2510 Tamiami Trl N
Nokomis, FL 34275
Phone (941) 966-1177

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1780742676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 PLACIDA RD STE 101",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234900",
            "telephone_number": "941-474-7170",
            "fax_number": "941-475-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 PLACIDA RD STE 101",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234900",
            "telephone_number": "941-474-7170",
            "fax_number": "941-475-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN R BERNSTEIN & ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "DOUTHWRIGHT",
        "authorized_official_first_name": "MERRI",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "ADMIN ASSISTANT",
        "authorized_official_telephone_number": "941-474-7170",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY 3297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033111200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENGLEWOOD COUNSELING",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.