Harborside Psychiatric Services, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

L07000124924 Issued in FL

Legal business name

HARBORSIDE PSYCHIATRIC SERVICES, LLC

Practice address

150 W. McKenzie Street
Suite #117
Punta Gorda, FL 33950

Phone

(941) 205-3333

Fax

(941) 205-3334

NPI assigned

Jan 1, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Joan E. Flynn, LCSW

Title

Partner

Phone

(941) 205-3333

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jill Husson Martinez, MD

  • Psychiatry Physician
  • Portland, ME
  • NPI 1588965503
  NPD (past)

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

{
    "created_epoch": "1199145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526515200000",
    "number": "1972788669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W. MCKENZIE STREET",
            "address_2": "SUITE #117",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339505500",
            "telephone_number": "941-205-3333",
            "fax_number": "941-205-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W. MCKENZIE STREET",
            "address_2": "SUITE #117",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "33950",
            "telephone_number": "941-205-3333",
            "fax_number": "941-205-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORSIDE PSYCHIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-01",
        "last_updated": "2018-05-17",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "941-205-3333",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7783",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "L07000124924",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME86547",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "L07000124924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266691001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Allan Hanson, DDS
• Harbor Audiology, P.a.
• Harbor View Acres, Inc.
• Harborside Dental Assoc Pca
• Harborside Internal Medicine PA
• Harborside Surgery Center, LLC
• Susan M Hardy, LCPC
• Richard Alan Haynes, LPTA
• Sony R Haynes, MPT
• Cynthia Lynn Highsmith Healy, LMHC

• Psychiatry Physician in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.