SHORELINE PSYCHOLOGICAL SERVICES, LLC (NPI# 1093257982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093257982 |
| Entity Type | Organization |
| Organization Name | SHORELINE PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
146 2nd St N Suite 310 St Petersburg FL 33701-3328 |
| Practice Telephone | 7272516874 |
| Mailing Telephone | 7272516874 |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |
| Authorized Official Name | DR. THEODORA COFFMAN (PSYCHOLOGIST) |
| Authorized Official Telephone | 7273081180 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PY9365 | FL | Behavioral Health & Social Service Providers |
| Street Address |
146 2ND ST N SUITE 310 |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33701-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922475599 | Theodora P Coffman | Psychologist | 146 2nd St N, Suite 310, St Petersburg, FL 33701-3328 | 2015-08-30 |
| 1972958262 | Travis Mcnulty | Counselor | 146 2nd St N, Suite 200, St Petersburg, FL 33701-3328 | 2016-04-25 |
| 1295193381 | John F Faber | Social Worker | 146 2nd St N, Suite 310, St Petersburg, FL 33701-3328 | 2016-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514603 | Tien Thuy Hoang | Pharmacist | 875 Dr M.l.k. Jr St N, St. Petersburg, FL 33701 | 2020-10-06 |
| 1851920953 | Michelle Tedrowe | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg Family Care Center, 700 6th Street South, St. Petersburg, FL 33701 | 2020-04-02 |
| 1164070264 | Melissa Joy Fitzpatrick | Occupational Therapist | 239 14 Ave Ne, St Petersburg, FL 33701 | 2019-09-01 |
| 1841763091 | William Carpenter Scott | Dentist | 239 2nd Ave S # 100, St Petersburg, FL 33701 | 2019-01-09 |
| 1992289318 | Westminster Senior Services, Inc. | Registered Nurse | 830 North Shore Dr. Ne, St. Petersburg, FL 33701 | 2018-09-21 |
| 1265929780 | B&b Florida Eye Care Pllc | Optometrist | 1380 4th St N, St. Petersburg, FL 33701 | 2018-04-19 |
| 1730684895 | Loraine Marie Torres Garcia | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg, 700 6th Street South, St Petersburg, FL 33701 | 2018-03-29 |
| 1598267445 | Vincent Malik Dehili | Psychologist | 146 2nd Street North, Suite 305, St. Petersburg, FL 33701 | 2018-03-07 |
| 1770083073 | Megan Sanborn | Nurse Practitioner | 601 5th St S Ste 304, St Petersburg, FL 33701 | 2018-02-14 |
| 1174037089 | Julius Griffin | Licensed Practical Nurse | 1115 Highland St N, Apt B, Saint Petersburg, FL 33701 | 2017-11-30 |
| Find all providers in zip 33701 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114406345 | Samantha Turetsky | Psychologist | 33 6th St S Ste 205, St Petersburg, FL 33701-4117 | 2018-08-08 |
| 1922475599 | Theodora P Coffman | Psychologist | 146 2nd St N, Suite 310, St Petersburg, FL 33701-3328 | 2015-08-30 |
| 1467837757 | Katherine Mcculloch | Psychologist | 415 14th Ave Ne, St Petersburg, FL 33701-1312 | 2015-07-28 |
| 1821494022 | David Brockway | Psychologist | 3730 18th Ave N, St Petersburg, FL 33713-4816 | 2014-11-15 |
| 1235404724 | Roberto Alves | Psychologist | 1913 Tyrone Blvd N, St Petersburg, FL 33710-4841 | 2012-03-15 |
| 1487989034 | Total Person Psychological Associates Pa | Psychologist | 6739 1st Avenue South, St Petersburg, FL 33707-0000 | 2009-10-14 |
| 1134375868 | Linda Appenfeldt, Ph.d., P.a. | Psychologist | 5400 Central Ave, St Petersburg, FL 33707-6131 | 2008-08-13 |
| 1134386444 | Lori I. Kleinman | Psychologist | 824 Bay St Ne, Apt. B, St Petersburg, FL 33701-2544 | 2008-05-22 |
| 1477710416 | Audra Mary Walsh | Psychologist | 777 4th St S, St Petersburg, FL 33701-4803 | 2008-05-19 |
| 1922292887 | Jason David Hangauer | Psychologist | 880 6th St S Ste 410, St Petersburg, FL 33701-4825 | 2007-09-04 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.