Organization Active NPI

Center for Psychology, PA

  • Clinical Neuropsychologist
  • Fort Myers, FL
National Provider Identifier
1952309296
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY0003794 Issued in FL
Legal business name
CENTER FOR PSYCHOLOGY, PA
Practice address
12499 Brantley Commons CT
Suite 101
Fort Myers, FL 33907-5676
Phone
(239) 278-3443
Fax
(239) 278-3550
NPI assigned
Jul 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Authorized official

Name
Dr. Steven D Cohen, PSY.DNPI 1447340369
Title
President
Phone
(239) 278-3443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X PY0003794 FL Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PY3794 FL
Health Service PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0100X PY3794 FL

Addresses

Primary practice location

12499 Brantley Commons CT
Suite 101
Fort Myers, FL 33907-5676

Mailing address

12499 Brantley Commons CT
Suite 101
Fort Myers, FL 33907-5676
Phone (239) 278-3443

Other names 1

  • Center for Psychology, PA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429000666 FL Part B Supplier - Clinic/Group Practice 0840287991 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

12499 Brantley Commons Ct
Ste 101
Fort Myers, FL 33907
Phone (239) 278-3443

1510 Royal Palm Square Blvd
Ste 105
Fort Myers, FL 33919
Phone (239) 245-8899

12499 Brantley Commons Ct
Fort Myers, FL 33907
Phone (239) 278-3443

7680 Cambridge Manor Pl
Ste 100
Fort Myers, FL 33907
Phone (239) 278-3443

12587 New Brittany Blvd
Bldg 21W
Fort Myers, FL 33907
Phone (239) 278-3443

5621 Strand Blvd
Ste 201
Naples, FL 34110

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1952309296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12499 BRANTLEY COMMONS CT",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075676",
            "telephone_number": "239-278-3443",
            "fax_number": "239-278-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12499 BRANTLEY COMMONS CT",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075676",
            "telephone_number": "239-278-3443",
            "fax_number": "239-278-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PSYCHOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-278-3443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY0003794",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY3794",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": "FL",
            "license": "PY3794",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Psychology, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.