Active NPI
Nathaly Shoua Desmarais, PSY.D.
- Psychologist
- Davie, FL
National Provider Identifier
1891928420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY7955
- Practice address
- 5400 S University Dr
Suite 119
Davie, FL 33328-5312 - Phone
- (954) 600-9190
- NPI assigned
- Aug 31, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY7955 | FL | Primary |
Addresses
Primary practice location
5400 S University Dr
Suite 119
Davie, FL 33328-5312
Mailing address
3000 SW 121St Ave
Davie, FL 33330-1318
Phone (954) 600-9190
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY7955 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251676800000",
"number": "1891928420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 SW 121ST AVE",
"city": "DAVIE",
"state": "FL",
"postal_code": "333301318",
"telephone_number": "954-600-9190",
"fax_number": "954-473-4267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 S UNIVERSITY DR",
"address_2": "SUITE 119",
"city": "DAVIE",
"state": "FL",
"postal_code": "333285312",
"telephone_number": "954-600-9190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESMARAIS",
"first_name": "NATHALY",
"middle_name": "SHOUA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-31",
"last_updated": "2009-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY7955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.