| Psychology Center Of Tampa Bay, Inc. | |
|
13357 N 56th St Tampa FL 33617-1161 | |
| (813) 914-9000 | |
| (813) 984-6907 |
| Full Name | Psychology Center Of Tampa Bay, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 13357 N 56th St, Tampa, Florida |
| Authorized Official Name and Position | Kristi E. Weiner (PRESIDENT) |
| Authorized Official Contact | 8139149000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychology Center Of Tampa Bay, Inc. 13357 N 56th St Tampa FL 33617-1161 Ph: (813) 914-9000 | Psychology Center Of Tampa Bay, Inc. 13357 N 56th St Tampa FL 33617-1161 Ph: (813) 914-9000 |
| NPI Number | 1740332568 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 06/18/2008 |
| Medicare PECOS PAC ID | 6002878329 |
|---|---|
| Medicare Enrollment ID | O20041029000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740332568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY6798 AND PY5055 (Florida) | Primary |
| Provider Name | Kristi E Weiner |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1396897120 PECOS PAC ID: 8022916568 Enrollment ID: I20031222000694 |
| Provider Name | Jaclyn L Lewis-croswell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649418948 PECOS PAC ID: 7214161082 Enrollment ID: I20131010000029 |
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