DR. ATHENA BOOLUKOS GORDON (NPI# 1700146552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700146552 |
| Entity Type | Individual |
| Full Name | DR. ATHENA BOOLUKOS GORDON |
| Credential | EDM, PSYD |
| Practice Address |
4201 Bayshore Blvd Unit 1603 Tampa FL 33611-1669 |
| Practice Telephone | 6177840771 |
| Mailing Telephone | 6177840771 |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PY8510 | FL | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
PY8510 | FL | Behavioral Health & Social Service Providers |
| Street Address |
4201 BAYSHORE BLVD UNIT 1603 |
| City | TAMPA |
| State | FL |
| Zip Code | 33611-1669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770844433 | Lifespan Psychology Services, LLC | Psychologist | 4201 Bayshore Blvd, Unit 1603, Tampa, FL 33611-1669 | 2012-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912519224 | Health & Glow Primary Care & Med Spa LLC | Internal Medicine | 4331 S Manhattan Ave, Tampa, FL 33611 | 2020-08-18 |
| 1245867597 | Susannah M Bultron | Home Health | 1663 Williambrg Sq, 1663 Williambrg Sq, Tampa, FL 33611 | 2020-03-26 |
| 1265077499 | Jenna Davis | Counselor | 4517 S Shamrock Rd, Tampa, FL 33611 | 2019-11-12 |
| 1023585114 | Samantha Lee Hamlin | Dietitian, Registered | 4003 S West Shore Blvd, Apt 4810, Tampa, FL 33611 | 2018-10-27 |
| 1023502572 | Sunset Chiropractic P.a. | Chiropractor | 3826 South Dale Mabry Hwy, South Tampa, FL 33611 | 2018-06-19 |
| 1033654843 | Nicole A Devlieger | Specialist/Technologist | 4539 S Dale Mabry Hwy Ste 110, Tampa, FL 33611 | 2017-01-03 |
| 1740633064 | Charles Lindsey | Case Manager/Care Coordinator | 5215 South Westshore Blvd. #31, Tampa, FL 33611 | 2016-07-21 |
| 1699145078 | Sarah Milam | Physical Therapist | 3111 W.martin Luther King Jr Blvd, Suite # 500, Tampa, FL 33611 | 2015-09-29 |
| 1912399163 | Robert Robertson | Pharmacist | 4317 Gandy Blvd, Tampa, FL 33611 | 2015-02-25 |
| 1730514225 | Charles Samuel Mahan | Obstetrics & Gynecology | 3111 E. Fletcher Av., Tampa, FL 33611 | 2013-09-04 |
| Find all providers in zip 33611 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063035392 | Dr Patti L Barrows Inc | Psychologist | 9403 Oak Meadow Ct, Tampa, FL 33647-2526 | 2020-05-21 |
| 1497313514 | Beth C. Boone, Ph.d., Pllc | Psychologist | Paragon Counseling - 14448 Bruce B Downs Blvd Fl 33613, Tampa, FL 33613-2612 | 2019-06-04 |
| 1205314804 | Advanced Behavior Center Inc | Psychologist | 5108 N Habana Ave Ste 1&2, Tampa, FL 33614-6822 | 2018-08-06 |
| 1962980292 | Kenya Latonya King | Psychologist | 14502 N Dale Mabry Highway, Tampa, FL 33618-2705 | 2018-07-30 |
| 1275024069 | Ulrike Barbara Wolter | Psychologist | 1209 E Cumberland Ave Unit 2801, Tampa, FL 33602-4262 | 2018-05-29 |
| 1225536287 | Interface Consulting and Psychological Services, LLC | Psychologist | 5606 N Nebraska Ave, Tampa, FL 33604-7124 | 2018-01-24 |
| 1437500246 | Sylvia Johnson | Psychologist | 11901 Middlebury Dr, Tampa, FL 33626-2521 | 2016-06-23 |
| 1306291067 | Melina Scally Psyd LLC | Psychologist | 1506 N 15th St, Tampa, FL 33605-5044 | 2016-05-02 |
| 1104283142 | Geeta R Arora | Psychologist | 5106 Lanai Way, Tampa, FL 33624-2537 | 2016-01-21 |
| 1245634294 | Child and Family Learing | Psychologist | 16105 Cadbury Ct, Tampa, FL 33647-1135 | 2014-10-20 |
| Find all providers in TAMPA | ||||
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| 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.