DR. MARK C KLISCH (NPI# 1366492878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366492878 |
| Entity Type | Individual |
| Full Name | DR. MARK C KLISCH |
| Credential | PH.D. |
| Practice Address |
4100 W Kennedy Blvd Suite 327 Tampa FL 33609-2288 |
| Practice Telephone | 8132888060 |
| Practice Fax Number | 8132888068 |
| Mailing Telephone | 8132888060 |
| Mailing Fax Number | 8132888068 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2008-02-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | PY3077 | FL | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY3077 | FL | Behavioral Health & Social Service Providers |
| Street Address |
4100 W KENNEDY BLVD SUITE 327 |
| City | TAMPA |
| State | FL |
| Zip Code | 33609-2288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366981946 | Foundations for Growth, Pllc | Social Worker | 4100 W Kennedy Blvd, Suite 326, Tampa, FL 33609-2288 | 2017-02-16 |
| 1922558733 | Bayada Home Health Care, Inc. | Home Health | 4100 W Kennedy Blvd, Suite 128, Tampa, FL 33609-2288 | 2016-10-05 |
| 1508311994 | Catalyst Center for Change LLC | Counselor | 4100 W Kennedy Blvd, Suite 210, Tampa, FL 33609-2288 | 2016-08-16 |
| 1699133660 | Scott Grupp | Counselor | 4100 W Kennedy Blvd, 210, Tampa, FL 33609 | 2016-02-05 |
| 1154700276 | Total Vitality Medical Group | Non-Pharmacy Dispensing Site | 4100 W Kennedy Blvd, Suite 114, Tampa, FL 33609-2288 | 2015-05-21 |
| 1801286752 | Holistic Psychology Services, LLC | Psychologist | 4100 W Kennedy Blvd, Suite 212, Tampa, FL 33609-2288 | 2015-01-30 |
| 1174934665 | Millyan Cabrera, Lmhc, Rpt | Counselor | 4100 W Kennedy Blvd, Suite 120, Tampa, FL 33609-2288 | 2014-05-19 |
| 1407277296 | International Rehabilitative Sciences Inc. | Durable Medical Equipment & Medical Supplies | 4100 W Kennedy Blvd, Ste 208, Tampa, FL 33609-2288 | 2013-12-20 |
| 1841639929 | An Awakened Heart Psychological Approaches Tomentalhealth Wellness LLC | Community/Behavioral Health | 4100 W Kennedy Blvd, 327, Tampa, FL 33609-2288 | 2013-06-21 |
| 1053653840 | Keesha Monaie Sullivan | Social Worker | 4100 W Kennedy Blvd, Suite 327, Tampa, FL 33609-2288 | 2013-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427521970 | Kampsen Hearing LLC | Audiologist | 310 South Macdill Avenue, Suite 202, Tampa, FL 33609 | 2019-01-08 |
| 1629557319 | Priscilla Luna-mitchum | Physical Therapist | 2700 W M.l.k Jr Blvd, Suite 300, Tampa, FL 33609 | 2018-08-13 |
| 1043735657 | Mary Elizabeth Osbach | Registered Nurse | 3211 W Swann Ave, Unit 1106, Tampa, FL 33609 | 2017-08-04 |
| 1497275317 | Jeilyn M Jimenez | Developmental Therapist | 550 N Reo Street, Tampa, FL 33609 | 2017-06-21 |
| 1033658513 | Adela Reeb | Specialist/Technologist | 909 North Dale Mabry Hwy, Tampa, FL 33609 | 2017-02-17 |
| 1033561261 | Abigail Marie Richardson | Developmental Therapist | 555 North Reo Street, Tampa, FL 33609 | 2016-07-12 |
| 1275992448 | Jennifer Stich | Behavioral Analyst | 3210 W De Leon St # B, Tampa, FL 33609 | 2016-02-16 |
| 1154711505 | Health E Systems, LLC | Transportation Broker | 5100 W. Lemon Street, Suite 311, Tampa, FL 33609 | 2015-01-23 |
| 1619375292 | Healthexchange Systems, LLC | Home Health | 5100 West Lemon Street, Suite 311, Tampa, FL 33609 | 2014-12-12 |
| 1538567458 | Calvin Harrison Iv | Occupational Therapist | 600 N. Westshore Blvd, Suite 600, Tampa, FL 33609 | 2014-12-09 |
| Find all providers in zip 33609 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744327 | Lisa Stewart | Psychologist | 13000 Bruce B Downs Blvd Bldg 68, Tampa, FL 33612-4745 | 2020-09-15 |
| 1205488012 | Kimberly Hubinger | Psychologist | 3825 Henderson Blvd Ste 505c, Tampa, FL 33629-5037 | 2019-07-11 |
| 1528537362 | Bethan Anne Roberts | Psychologist | 13000 Bruce B Downs Blvd Rm 163, Tampa, FL 33612-4745 | 2018-11-23 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1962979583 | Rosana Marzullo-dove | Psychologist | 912 W Platt St Ste 101, Tampa, FL 33606-2108 | 2018-11-01 |
| 1740764158 | Fabian Alexandro Consbruck | Psychologist | 5425 Beaumont Center Blvd Ste 918, Tampa, FL 33634-5214 | 2018-09-20 |
| 1154810802 | Lashley Marks | Psychologist | 4202 E Fowler Ave Stop Svc2124, Tampa, FL 33620-6970 | 2018-05-08 |
| 1922595305 | Carmen Ana Gonzalez-magaz | Psychologist | 836 S Davis Blvd, Tampa, FL 33606-4025 | 2018-04-20 |
| 1811494982 | Adam Zimmer | Psychologist | 4202 E Fowler Ave Shs 100, Tampa, FL 33620-6750 | 2018-04-06 |
| 1326553389 | My Psychology Place Inc. | Psychologist | 6601 Memorial Hwy Ste 310, Tampa, FL 33615-4501 | 2017-12-12 |
| Find all providers in TAMPA | ||||
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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.