Provider Demographics
NPI:1790926335
Name:FLORIDA PSYCHOLOGY SERVICES, LLC
Entity Type:Organization
Organization Name:FLORIDA PSYCHOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MADSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:407-267-1060
Mailing Address - Street 1:PO BOX 865
Mailing Address - Street 2:
Mailing Address - City:APALACHICOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32329-0865
Mailing Address - Country:US
Mailing Address - Phone:407-267-1060
Mailing Address - Fax:
Practice Address - Street 1:41 COMMERCE ST UNIT B
Practice Address - Street 2:
Practice Address - City:APALACHICOLA
Practice Address - State:FL
Practice Address - Zip Code:32320-1771
Practice Address - Country:US
Practice Address - Phone:407-267-1060
Practice Address - Fax:850-653-1602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-11
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7417103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty