NPIMap

Organization Active NPI

Holistic Psychology Services, LLC

  • Psychologist
  • Tampa, FL
National Provider Identifier
1801286752
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8475 Issued in FL
Legal business name
HOLISTIC PSYCHOLOGY SERVICES, LLC
Practice address
4100 W Kennedy Blvd
Suite 212
Tampa, FL 33609-2288
Phone
(312) 316-1391
Fax
(813) 225-5678
NPI assigned
Jan 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Dr. Shana StowitzkyNPI 1376816074
Title
Clinical Psychologist
Phone
(312) 316-1391

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 8475 FL Primary

Addresses

Primary practice location

4100 W Kennedy Blvd
Suite 212
Tampa, FL 33609-2288

Mailing address

4100 W Kennedy Blvd
Suite 212
Tampa, FL 33609-2288
Phone (312) 316-1391

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150310002378 FL Part B Supplier - Clinic/Group Practice 3577889567 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

8455 W Linebaugh Ave
Tampa, FL 33625
Phone (813) 600-5144

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1801286752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 W KENNEDY BLVD",
            "address_2": "SUITE 212",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092288",
            "telephone_number": "312-316-1391",
            "fax_number": "813-225-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W KENNEDY BLVD",
            "address_2": "SUITE 212",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092288",
            "telephone_number": "312-316-1391",
            "fax_number": "813-225-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC PSYCHOLOGY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "STOWITZKY",
        "authorized_official_first_name": "SHANA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-316-1391",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "8475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.