Inner Discovery Mental Health Services, PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

INNER DISCOVERY MENTAL HEALTH SERVICES, PLLC

Practice address

4848 Grapevine Way
Davie, FL 33331-3358

Phone

(786) 499-2926

NPI assigned

Jun 19, 2023

Organization subpart

No

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

Authorized official

Name

Carolina Kaack, APRN

Title

Ceo/ Psychiatric Nurse Practitioner

Phone

(786) 499-2926

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1952086928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4474 WESTON RD # 1097",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333313195",
            "telephone_number": "754-333-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 GRAPEVINE WAY",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333313358",
            "telephone_number": "786-499-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER DISCOVERY MENTAL HEALTH SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-18",
        "status": "A",
        "authorized_official_last_name": "KAACK",
        "authorized_official_first_name": "CAROLINA",
        "authorized_official_title_or_position": "CEO/ PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "786-499-2926",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295253870",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Davie, FL
• Providers in Davie, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.