LIFESPAN PSYCHIATRIC CARE (NPI# 1952828790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952828790 |
| Entity Type | Organization |
| Organization Name | LIFESPAN PSYCHIATRIC CARE |
| Practice Address |
4800 Linton Blvd Ste D502a Delray Beach FL 33445-6593 |
| Mailing Address |
701 S Olive Ave Apt 407 West Palm Beach FL 33401-6195 |
| Practice Telephone | 5618087205 |
| Practice Fax Number | 5615846804 |
| Mailing Telephone | 5613077745 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |
| Authorized Official Name | NICHOLAS J JACKSON (OWNER) |
| Authorized Official Telephone | 5613077745 |
| Authorized Official Credential | PMHNP-BC, ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
9294269 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4800 LINTON BLVD STE D502A |
| City | DELRAY BEACH |
| State | FL |
| Zip Code | 33445-6593 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346894839 | Timothy Joseph Marten Jr. | Physical Therapist | 601 N Congress Ave 411, Delray Beach, FL 33445 | 2019-08-01 |
| 1881252948 | Three Dots LLC | Behavioral Analyst | 1300 Nw 17th Ave Ste 272, Delray Beach, FL 33445 | 2019-06-04 |
| 1437649951 | Cardinal Care Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 601 N Congress Ave Ste 110b, Delray Beach, FL 33445 | 2018-05-10 |
| 1437654001 | Yvonne Marie Venton | Speech-Language Pathologist | 1221 Nw 19th Ter, Delray Beach, FL 33445 | 2018-03-27 |
| 1265935183 | Robert J Pina | Physical Therapist | 4800 Linton Blvd., Bldg. A-201, Delray Beach, FL 33445 | 2018-03-16 |
| 1447771159 | Julian Ibrahim Rashid | Pharmacist | 3030 Dorson Way, Delray Beach, FL 33445 | 2017-07-03 |
| 1285179333 | Sara Davis-larkins | Behavioral Analyst | 2061 Coral Trace Circle, Delray Beach, FL 33445 | 2016-12-28 |
| 1255876637 | Annette Annmarie Gray | Case Manager/Care Coordinator | 3624 Ave De Gien, Delray Beach, FL 33445 | 2016-12-21 |
| 1093262586 | Gordium Mental Health | Counselor | 4723 W Atlantic Ave St 21, Delray Beach, FL 33445 | 2016-09-01 |
| 1003279993 | Ted Paul | Home Health Aide | 2127 Sw 13 Ct, Delray Beach, FL 33445 | 2016-03-30 |
| Find all providers in zip 33445 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194360354 | Courtney Larue | Nurse Practitioner | 954 Kokomo Key Ln, Delray Beach, FL 33483-6032 | 2019-11-12 |
| 1811352925 | Brittany Brooke Ullman | Nurse Practitioner | 707 Lake Ave N, Delray Beach, FL 33483-5927 | 2015-12-17 |
| 1316917347 | Natalie Wilgoren | Nurse Practitioner | 72 Ne 5th Ave, Delray Beach, FL 33483-5427 | 2006-01-23 |
| 1528575925 | Maykelyn Felipe | Nurse Practitioner | 403 Se 1st St, Delray Beach, FL 33483-4540 | 2018-01-08 |
| 1326391608 | Lisa Worthy | Nurse Practitioner | 16158 S Military Trl, Delray Beach, FL 33484-6502 | 2012-10-24 |
| 1194963637 | Daniel Michael Cousens | Nurse Practitioner | 16158 S Military Trl, Delray Beach, FL 33484-6502 | 2009-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336832 | Marco Desouza | Nurse Practitioner | 10235 Avelar Ridge Dr, Riverview, FL 33578-7560 | 2020-11-02 |
| 1457950107 | Janet Rosemarie Walker | Nurse Practitioner | 9988 Sw 38th Ave, Ocala, FL 34476-4082 | 2020-10-23 |
| 1104425800 | Vijayalakshmi Kumaraguru | Nurse Practitioner | 102 Park Place Blvd Ste D1, Kissimmee, FL 34741-2358 | 2020-10-22 |
| 1356940217 | Smitha Ajesh | Nurse Practitioner | 9833 Westview Dr Apt 829, Coral Springs, FL 33076-2537 | 2020-10-21 |
| 1457959066 | Kecia Hicks | Nurse Practitioner | 691 Institution Rd, Defuniak Springs, FL 32433-1850 | 2020-10-15 |
| 1699372003 | Rosie Michel | Nurse Practitioner | 13000 Ne 12th Ave, North Miami, FL 33161-4305 | 2020-10-08 |
| 1952908352 | Karen Weinstock | Nurse Practitioner | 7148 Sportsmans Dr, North Lauderdale, FL 33068-5456 | 2020-10-08 |
| 1396342754 | Pamela Ziel | Nurse Practitioner | 545 Lakeside Cir, Sunrise, FL 33326-2136 | 2020-10-07 |
| 1922615608 | Urszula Dorfman | Nurse Practitioner | 1 Las Olas Cir Apt 609, Fort Lauderdale, FL 33316-1634 | 2020-09-28 |
| 1073129136 | Karen Harris | Nurse Practitioner | 28211 Church Rd, Brooksville, FL 34602-6232 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
| City | DELRAY BEACH |
| Zip Code | 33445 |
Please comment or provide details below to improve the information on LIFESPAN PSYCHIATRIC CARE.
| 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.