Individual provider Active NPI

Dexter Simanton, PSY.D

  • Mental Health Counselor
  • Maitland, FL
National Provider Identifier
1932288172
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PY0004951 Issued in FL
Practice address
260 Lookout PL # 202
Maitland, FL 32751-4492
Phone
(407) 647-1781
Fax
(407) 647-4628
NPI assigned
Nov 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Mental Health Counselor 101YM0800X PY0004951 FL Primary

Addresses

Primary practice location

260 Lookout PL # 202
Maitland, FL 32751-4492

Mailing address

260 Lookout PL # 202
Maitland, FL 32751-4492
Phone (407) 647-1781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2017 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PY0004951FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932288172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 LOOKOUT PL # 202",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514492",
            "telephone_number": "407-647-1781",
            "fax_number": "407-647-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 LOOKOUT PL # 202",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514492",
            "telephone_number": "407-647-1781",
            "fax_number": "407-647-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMANTON",
        "first_name": "DEXTER",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "PY0004951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.