Fort Lauderdale Psychology PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY: 8799 Issued in FL

Legal business name

FORT LAUDERDALE PSYCHOLOGY PA

Practice address

2755 E Oakland Park Blvd
Suite 225
Fort Lauderdale, FL 33306-1637

Phone

(954) 260-8790

NPI assigned

Mar 27, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Nicolle Anne Deleo, LMHC PSYDNPI 1841528874

Title

Owner/President

Phone

(954) 260-8790

Specialties & licenses 2

Addresses

Tax ID family

Fort Lauderdale Psychology PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nicolle Deleo LMHC PSYD PA

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1063750347
  NPD tax ID

Locations

Practitioners 1

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

• Nicolle Anne Deleo, PSY D

  • Counseling Psychologist
  • Fort Lauderdale, FL
  • NPI 1841528874

  Mental Health

  NPD (past) Authorized official

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1912438375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NE 3RD AVE",
            "address_2": "#305",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333011291",
            "telephone_number": "954-260-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 E OAKLAND PARK BLVD",
            "address_2": "SUITE 225",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061637",
            "telephone_number": "954-260-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT LAUDERDALE PSYCHOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "DELEO",
        "authorized_official_first_name": "NICOLLE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "954-260-8790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LMHC PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH:10032",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY: 8799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.