1912132416 NPI number — EILEEN MESSING PSYD PA

Table of content: KLENDY SAMANTHA GREER (NPI 1831687789)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912132416 NPI number — EILEEN MESSING PSYD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EILEEN MESSING PSYD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912132416
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7499 W ATLANTIC AVE
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33446-1395
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-499-1919
Provider Business Mailing Address Fax Number:
561-208-5722

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7499 W ATLANTIC AVE
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
DELRAY BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33446-1395
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-499-1919
Provider Business Practice Location Address Fax Number:
561-208-5722
Provider Enumeration Date:
05/28/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MESSING
Authorized Official First Name:
EILEEN
Authorized Official Middle Name:
ELIZABETH
Authorized Official Title or Position:
LICENSED PSYCHOLOGIST
Authorized Official Telephone Number:
561-499-1919

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  PY5862 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: PY5862 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 103856000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com