Individual provider Active NPI

Betty Jo Ehlert, PH.D.

  • Clinical Psychologist
  • Palm Beach Gardens, FL
National Provider Identifier
1861414757
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 4147 Issued in FL
Practice address
600 Sandtree Dr
Suite 202 D
Palm Beach Gardens, FL 33403-1597
Phone
(561) 691-1808
Fax
(561) 691-1983
NPI assigned
Jul 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 4147 FL Primary

Addresses

Primary practice location

600 Sandtree Dr
Suite 202 D
Palm Beach Gardens, FL 33403-1597

Mailing address

10423 153Rd CT N
Jupiter, FL 33478-6819
Phone (561) 745-3149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY 4147FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861414757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10423 153RD CT N",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334786819",
            "telephone_number": "561-745-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SANDTREE DR",
            "address_2": "SUITE 202 D",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031597",
            "telephone_number": "561-691-1808",
            "fax_number": "561-691-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLERT",
        "first_name": "BETTY",
        "middle_name": "JO",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 4147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.