PROFESSIONAL CLINICAL SERVICES OF WI 1 LLC (NPI# 1508133158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508133158 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL CLINICAL SERVICES OF WI 1 LLC |
| Practice Address |
292 Old Dixie Hwy Vero Beach FL 32962-2947 |
| Practice Telephone | 7724942700 |
| Practice Fax Number | 7725628127 |
| Mailing Telephone | 7724942700 |
| Mailing Fax Number | 7725628127 |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |
| Authorized Official Name | MR. DAVID EDWARD SOMMERFELD (MANAGER) |
| Authorized Official Telephone | 7724942700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 102L00000X | Psychoanalyst | Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| N | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers | ||
| N | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
Behavioral Health & Social Service Providers | ||
| N | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
Behavioral Health & Social Service Providers | ||
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
292 OLD DIXIE HWY |
| City | VERO BEACH |
| State | FL |
| Zip Code | 32962-2947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811512577 | Brennen T Murphy | Behavior Technician | 2036 15th St Sw, Vero Beach, FL 32962 | 2020-06-09 |
| 1912426289 | Dacia Rose Swartz | Technician, Other | 241 14th. St. Sw, Vero Beach, FL 32962 | 2017-09-18 |
| 1336688670 | Diamond Behavioral Services | Behavior Technician | 460 7th Place, Vero Beach, FL 32962 | 2017-02-20 |
| 1093148736 | Ashley Ann Baum | Nurse Practitioner | 1545 9th St. S.w., Vero Beach, FL 32962 | 2013-08-16 |
| 1215379631 | Charlene Marylee Foulk | Nurse's Aide | 985 23rd Place Sw, Vero Beach, FL 32962 | 2013-07-26 |
| 1295028314 | John Robert Moore | Behavioral Analyst | 815 24th St Sw, Vero Beach, FL 32962 | 2011-05-23 |
| 1801042825 | Celena Benjamin | Counselor | 950 6th Ln, Vero Beach, FL 32962 | 2008-08-10 |
| 1881882736 | Mary K Mackanos | Massage Therapist | 396 10th Ct, Vero Beach, FL 32962 | 2007-10-04 |
| 1659494813 | Shirley Ann Allen | Home Health Aide | 2155 15 St Sw, Oslo Park, Vero Beach, FL 32962 | 2007-04-10 |
| 1740347343 | Charles Kerth Stewart | Veterinarian | 890 Old Dixie Highway Sw, Live Oak Animal Hospital, Vero Beach, FL 32962 | 2007-01-02 |
| Find all providers in zip 32962 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619390580 | Susana Quintana Marikle | Psychologist | 9555 Frangipani Dr, Vero Beach, FL 32963-4524 | 2014-01-29 |
| 1255620423 | Renee Zielinski Keller | Psychologist | 1515 Indian River Blvd Ste A210, Vero Beach, FL 32960-7107 | 2011-03-28 |
| 1275783193 | Barbara Lynn Morrison Williams | Psychologist | 725 Flamevine Ln, Vero Beach, FL 32963-1902 | 2008-09-28 |
| 1508087933 | Garry L. Edwards | Psychologist | 1627 14th Ave, Vero Beach, FL 32960-0435 | 2007-05-02 |
| 1326268848 | Carole Lilli Strauss | Psychologist | 2525 20th St, Vero Beach, FL 32960-3026 | 2007-04-26 |
| 1821165168 | Molly M Snell | Psychologist | 570 N Tropic Ln, Unit D, Vero Beach, FL 32960 | 2006-11-30 |
| 1073530630 | Galit Shalom-craig | Psychologist | 655 Camelia Ln, Vero Beach, FL 32963-1841 | 2006-07-17 |
| 1326075144 | David Sjur Holland | Psychologist | 1031 Royal Palm Blvd, Vero Beach, FL 32960-5341 | 2006-06-27 |
| 1881671386 | Fred J Petrilla Jr. | Psychologist | 1903 25th St, Vero Beach, FL 32960-3366 | 2005-12-27 |
| 1316934607 | Daryl Lynn Millman | Psychologist | 2770 Indian River Blvd., Suite 313, Vero Beach, FL 32960-6550 | 2005-10-01 |
| Find all providers in VERO BEACH | ||||
| City | VERO BEACH |
| Zip Code | 32962 |
Please comment or provide details below to improve the information on PROFESSIONAL CLINICAL SERVICES OF WI 1 LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.