Paula Deforest PHD LLC

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY0004766 Issued in FL

Legal business name

PAULA DEFOREST PHD LLC

Practice address

1425 Aurora Rd
Melbourne, FL 32935-5315

Phone

(321) 242-3110

NPI assigned

Jul 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Paula DeforestNPI 1306081179

Title

Psychologist

Phone

(321) 305-5068

Specialties & licenses 8

Addresses

Other names 1

• Paula DeForest PhD Doing business as

Practitioners 7

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

• Paula Deforest, PHD

  • Clinical Child & Adolescent Psychologist
  • West Melbourne, FL
  • NPI 1306081179
  NPD (past) Authorized official
• Larenda Ann Duley, LCSW

  • Clinical Social Worker
  • Melbourne, FL
  • NPI 1861500647
  NPD (past)
• Kellie Garza, LMHC

  • Mental Health Counselor
  • Melbourne, FL
  • NPI 1275687162
  NPD (past)
• Jenny Gessler, PH.D.

  • Mental Health Counselor
  • Melbourne, FL
  • NPI 1326226408
  NPD (past)
• Jennifer Catapano Guarino, LMHC

  • Mental Health Counselor
  • Melbourne, FL
  • NPI 1952655052
  NPD (past)
• Susan Nelson Kiley, L.M.H.C

  • Mental Health Counselor
  • Melbourne, FL
  • NPI 1043260417
  NPD (past)
• Michelle Lawrence, LMHC/MCAP

  • Mental Health Counselor
  • Pensacola, FL
  • NPI 1023479078
  NPD (past)

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437696000000",
    "number": "1851776348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 ROCKLEDGE DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329555404",
            "telephone_number": "321-305-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 AURORA RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355315",
            "telephone_number": "321-242-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULA DEFOREST PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-07-24",
        "status": "A",
        "authorized_official_last_name": "DEFOREST",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "321-305-5068",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY0004766",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY0004766",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0004766",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY0004766",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY0004766",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "FL",
            "license": "PY0004766",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "FL",
            "license": "PY0004766",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "PY0004766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paula DeForest PhD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diana Elizabeth Patterson, APRN, FNP-C
• Erica Patton, NNP-BC
• Kelly Ann Patton
• Vikas Pattu, MD
• Paul G Rousseau OD PA
• Leigh Ann Pauley, DC
• Ronda Michele Paulick
• Rosemarie Padama Pavia, APRN
• Nicole Barbara Pawlicki, PHARMD
• Ralph R. Paylor, MD

• Clinical Child & Adolescent Psychologist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Clinical Child & Adolescent Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.