| Neurodivergent Empowerment Institue Inc | |
|
146 2nd St N Ste 101 St Petersburg FL 33701-3361 | |
| (727) 490-9911 | |
| Not Available |
| Full Name | Neurodivergent Empowerment Institue Inc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 146 2nd St N Ste 101, St Petersburg, Florida |
| Authorized Official Name and Position | Angela Fisher (CMO) |
| Authorized Official Contact | 7274909911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurodivergent Empowerment Institue Inc 146 2nd St N Ste 101 St Petersburg FL 33701-3361 Ph: (727) 490-9911 | Neurodivergent Empowerment Institue Inc 146 2nd St N Ste 101 St Petersburg FL 33701-3361 Ph: (727) 490-9911 |
| NPI Number | 1578385092 |
|---|---|
| Provider Enumeration Date | 10/26/2024 |
| Last Update Date | 03/02/2025 |
| Certification Date | 03/02/2025 |
| Medicare PECOS PAC ID | 0244755148 |
|---|---|
| Medicare Enrollment ID | O20250423000607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578385092 | NPI | - | NPPES |
| Provider Name | Dallas Carey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023516150 PECOS PAC ID: 3072867852 Enrollment ID: I20181114000824 |
| Provider Name | Samuel Choura |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134781131 PECOS PAC ID: 7911346580 Enrollment ID: I20240416000113 |
| Provider Name | Kayden Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619784162 PECOS PAC ID: 4486173846 Enrollment ID: I20250528003889 |
| Provider Name | Arielle Sarah Bernhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215792296 PECOS PAC ID: 1254840135 Enrollment ID: I20250602003534 |
| Provider Name | Margaret Oconnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215330584 PECOS PAC ID: 6002130846 Enrollment ID: I20250610003011 |
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