Active NPI
Charu Jain PSYD LLC
- Clinical Psychologist
- Plantation, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY9137
- Legal business name
- CHARU JAIN PSYD LLC
- Practice address
- 7420 NW 5TH St Ste 103
Plantation, FL 33317-1611 - Phone
- (954) 817-6372
- NPI assigned
- Mar 25, 2015
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Mrs. Charu Jain, PSYD
- Title
- President
- Phone
- (954) 817-6372
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychologist
- Plantation, FL
- NPI 1225050107
-
- Mental Health Counselor
- Fort Lauderdale, FL
- NPI 1316138563
-
- Clinical Social Worker
- Greensboro, NC
- NPI 1730179573
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161219001902 | FL | Part B Supplier - Clinic/Group Practice | 0840571444 |
Receives reassigned benefits from 1 practitioner Practice locations: Plantation, FL |
National Provider Directory
National Provider Directory- Tax ID family
- Broward Psychology Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Psychologist
- Plantation, FL
- NPI 1396296810
Locations
1112 SE 3rd Ave
Fort Lauderdale, FL 33316
Phone (954) 817-6372
150 S University Dr
Ste 150A
Plantation, FL 33324
300 NW 70th Ave
Ste 107
Plantation, FL 33317
Phone (954) 530-0848
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY9137 | FL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
7420 NW 5TH St Ste 103
Plantation, FL 33317-1611
Mailing address
7420 NW 5TH St Ste 103
Plantation, FL 33317-1611
Phone (954) 817-6372
Other names 1
NPPES NPI Registry- Broward Psychology Center
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 29, 2020.
{
"created_epoch": "1427241600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1601337600000",
"number": "1962896191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7420 NW 5TH ST STE 103",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333171611",
"telephone_number": "954-817-6372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7420 NW 5TH ST STE 103",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333171611",
"telephone_number": "954-817-6372"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARU JAIN PSYD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-03-25",
"last_updated": "2020-09-29",
"certification_date": "2020-09-29",
"status": "A",
"authorized_official_last_name": "JAIN",
"authorized_official_first_name": "CHARU",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "954-817-6372",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "PSYD"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY9137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Broward Psychology Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Broward Psychology Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.