Provider Demographics
NPI:1437243961
Name:FLORIDA CENTER FOR COGNITIVE THERAPY, INC.
Entity Type:Organization
Organization Name:FLORIDA CENTER FOR COGNITIVE THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-791-0886
Mailing Address - Street 1:1201 COUNTY ROAD 1
Mailing Address - Street 2:SUITE A
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-4655
Mailing Address - Country:US
Mailing Address - Phone:727-791-0886
Mailing Address - Fax:727-735-0859
Practice Address - Street 1:1201 COUNTY ROAD 1
Practice Address - Street 2:SUITE A
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-4655
Practice Address - Country:US
Practice Address - Phone:727-791-0886
Practice Address - Fax:727-735-0859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003816103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75906Medicare ID - Type UnspecifiedPSYCHOLOGIST
FL75916Medicare ID - Type UnspecifiedPSYCHOLOGIST