Amy Melissa Mulholland, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY6605 Issued in FL

Practice address

6150 Diamond Centre CT Unit 1003
Fort Myers, FL 33912-7135

Phone

(239) 561-9955

Fax

(239) 561-9779

NPI assigned

Sep 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Pooja Shastri, Psy.D., P.a.

  • Clinical Psychologist
  • Fort Myers, FL
  • NPI 1891334157
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831281690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT UNIT 1003",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339127135",
            "telephone_number": "239-561-9955",
            "fax_number": "239-561-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT UNIT 1003",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339127135",
            "telephone_number": "239-561-9955",
            "fax_number": "239-561-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHOLLAND",
        "first_name": "AMY",
        "middle_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY6605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL IND.PROVIDER #",
            "identifier": "54869",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL GROUP PRACTICE",
            "identifier": "74976",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nura Muhammad, FNP
• Amit Martin Mukhia, M.D.
• Alison C Mulcahey, ARNP
• Holly Ann Mulhern, AUD, CCC-A
• Keri Ann Mulhern, DNP, CRNA
• Arthur Muller, D.O.
• Elenita Masamong Mulles, PT
• Gerard Mulles, MD
• Mayflor Q Mulles, P.T.
• Suzanne Louise Mullin, PT

• Counseling Psychologist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.