Provider Demographics
NPI:1235175290
Name:DELANEY, CAROL JEAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:JEAN
Last Name:DELANEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9425 SW 72ND ST
Mailing Address - Street 2:STE 265
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5457
Mailing Address - Country:US
Mailing Address - Phone:305-595-2590
Mailing Address - Fax:305-595-3746
Practice Address - Street 1:9425 SW 72ND ST
Practice Address - Street 2:STE 265
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5457
Practice Address - Country:US
Practice Address - Phone:305-595-2590
Practice Address - Fax:305-595-3746
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL#PY5934103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54613Medicare ID - Type Unspecified