Psychological Associates of Melbourne, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PSYCHOLOGICAL ASSOCIATES OF MELBOURNE, INC.

Practice address

1825 Riverview Dr
Melbourne, FL 32901-4711

Phone

(321) 541-1250

Fax

(321) 951-1928

NPI assigned

May 3, 2010

Last updated

Feb 26, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Wende J Anderson, PSYDNPI 1952477143

Title

President

Phone

(321) 541-1250

Specialties & licenses 2

Addresses

Other names 1

• WENDE J ANDERSON PSYD PA Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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.

• Wende J Anderson, PSYD

  • Clinical Psychologist
  • Melbourne, FL
  • NPI 1952477143
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677369600000",
    "number": "1851618771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N PALM AVE UNIT 33850",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329035034",
            "telephone_number": "321-541-1250",
            "fax_number": "321-951-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 RIVERVIEW DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329014711",
            "telephone_number": "321-541-1250",
            "fax_number": "321-951-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL ASSOCIATES OF MELBOURNE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-03",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "WENDE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-541-1250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 7426",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WENDE J ANDERSON PSYD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "WENDE J ANDERSON PSYD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Christian Cameron Prusinski, DO
• Christopher J Prusinski, DO
• Alexis Pryor
• Mark S Psarakis, MD
• Psychiatric Care Associates LLC
• Psychology Associates of Brevard PLC
• Publix Super Markets Inc (Publix Pharmacy #2089)
• Publix Super Markets Inc (Publix Pharmacy #0704)
• Publix Super Markets Inc (Publix Pharmacy #0738)
• Publix Super Markets Inc (Publix Pharmacy #0467)

• Clinical Psychologist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2023; 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.