Mimi Okazaki, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY5672 Issued in FL

Practice address

100 N Main St
Building 1053
Chattahoochee, FL 32324-1107

Phone

(850) 663-7807

NPI assigned

Aug 31, 2011

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 31, 2011.

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1861773145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N MAIN ST",
            "address_2": "BUILDING 1053",
            "city": "CHATTAHOOCHEE",
            "state": "FL",
            "postal_code": "323241107",
            "telephone_number": "850-663-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MAIN ST",
            "address_2": "BUILDING 1053",
            "city": "CHATTAHOOCHEE",
            "state": "FL",
            "postal_code": "323241107",
            "telephone_number": "850-663-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAZAKI",
        "first_name": "MIMI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5672",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY 3284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Chattahoochee, FL
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.