Individual provider Active NPI

Sharon Rifkin Thetford, PSY.D.

  • Clinical Psychologist
  • Longwood, FL
National Provider Identifier
1952441560
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0004578 Issued in FL
Practice address
620 Crown Oak Centre Dr
Longwood, FL 32750-6188
Phone
(407) 339-1159
Fax
(407) 339-2405
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0004578 FL Primary

Addresses

Primary practice location

620 Crown Oak Centre Dr
Longwood, FL 32750-6188

Mailing address

620 Crown Oak Centre Dr
Longwood, FL 32750-6188
Phone (407) 339-1159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200721001655 FL Practitioner - Clinical Psychologist 6204062052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

370 Centerpointe Cir
Suite 1160
Altamonte Springs, FL 32701-3458
Phone (407) 339-1159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY0004578FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Objectives Psychology, Counseling & Neurofeedback Center CurrentSince Oct 15, 2013 Accepting new patients

Locations

370 Centerpointe Cir
Ste 1160
Altamonte Springs, FL 32701
Phone (407) 339-1159

620 Crown Oak Centre Dr
Longwood, FL 32750
Phone (407) 339-1159

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1952441560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 CROWN OAK CENTRE DR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506188",
            "telephone_number": "407-339-1159",
            "fax_number": "407-339-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CROWN OAK CENTRE DR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506188",
            "telephone_number": "407-339-1159",
            "fax_number": "407-339-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THETFORD",
        "first_name": "SHARON",
        "middle_name": "RIFKIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0004578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.