Gateway Psychological Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY 8375 Issued in FL

Legal business name

GATEWAY PSYCHOLOGICAL SERVICES, LLC

Practice address

11300 4TH St N
Suite 115
St Petersburg, FL 33716-2918

Phone

(727) 619-4477

Fax

(727) 258-2348

NPI assigned

Nov 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Michael Missory, PSY.D.NPI 1437431509

Title

Owner

Phone

(737) 619-4477

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Michael Patrick Missory, PSY.D

  • Clinical Psychologist
  • St Petersburg, FL
  • NPI 1437431509
  Medicare reassignment NPD Authorized official
• Marissa M Petralia, PH.D.

  • Clinical Psychologist
  • Naples, FL
  • NPI 1841504966
  NPD (past)

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1992257240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 4TH ST N",
            "address_2": "SUITE 115",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337162918",
            "telephone_number": "727-619-4477",
            "fax_number": "727-258-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 4TH ST N",
            "address_2": "SUITE 115",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337162918",
            "telephone_number": "727-619-4477",
            "fax_number": "727-258-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "MISSORY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "737-619-4477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 8375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Leonard Gary Jr., DDS
• Maria D Gascon, LMHC
• Virginia Gaskins, MS, LMHC
• Gastro Pharmacy LLC
• Gateway Manor
• Gateway Radiology Consultants PA
• Gateway Radiology Consultants PA
• Alivia Gatewood
• Betty J Gathers, CCCE, CLD, CTSP
• Carolyn Marie Gaulden, MD, MBA, MSW

• Psychologist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.