Dr Psychologist LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

DR PSYCHOLOGIST LLC

Practice address

26829 Tanic Dr Ste 101
Wesley Chapel, FL 33544-4612

Phone

(813) 219-0152

NPI assigned

Jan 26, 2022

Organization subpart

No

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

Authorized official

Name

Jessica Pena MoralesNPI 1639318819

Title

Owner

Phone

(813) 219-0152

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Jessica J Pena Morales, PSY.D.

  • Clinical Psychologist
  • Wesley Chapel, FL
  • NPI 1639318819
  Medicare reassignment NPD Authorized official
• Aymara Del Toro- Acevedo

  • Mental Health Counselor
  • Wesley Chapel, FL
  • NPI 1659296291
  NPD (past)

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1942952312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870 SATILLA LOOP",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335562736",
            "telephone_number": "813-219-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26829 TANIC DR STE 101",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335444612",
            "telephone_number": "813-219-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR PSYCHOLOGIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "PENA MORALES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-219-0152"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Dowd
• Kyle A Downing
• Dr Christian Berrios PA
• Dr Eid MD LLC
• Dr Nydia Conrad & Associates Inc
• Dr Toshiya Arciaga & Associates Inc
• Dr. Brian Tribunella and Associates Inc
• Dr. Nydia Conrad Counseling & Psychological Assessment Services, LLC
• Dr. Susan P. Phillips, PH.D. LLC
• Sarah Kathryn Drapela, CNM, NP-C, RN

• Clinical Psychologist in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.