Potential Psychological Services Corp

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW8851 Issued in FL

Legal business name

POTENTIAL PSYCHOLOGICAL SERVICES CORP

Practice address

13220 Scharber Rd
Dade City, FL 33525-8008

Phone

(352) 588-5135

NPI assigned

Jun 11, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Daryl D. Bozone, LCSWNPI 1003086489

Title

President

Phone

(352) 588-5135

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

• Daryl D Bozone, LCSW

  • Clinical Social Worker
  • Dade City, FL
  • NPI 1003086489

  Clinical, FL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1992186399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13220 SCHARBER RD",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335258008",
            "telephone_number": "352-588-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13220 SCHARBER RD",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335258008",
            "telephone_number": "352-588-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTENTIAL PSYCHOLOGICAL SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "BOZONE",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-588-5135",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seida Perez, LMHC
• Thanh Pham
• Parag Pitroda, MD
• Dayanara Polanco
• Grace Portoghese, OT
• Potentiel Illimite Corp
• Premier Community Health Care Group, Inc.
• Premier Community Health Care Group, Inc.
• Premier Community Healthcare Group Inc
• Premier Community Healthcare Group, Inc

• All providers in Dade City, FL
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.