Healthcare Provider Details

I. General information

NPI: 1760718910
Provider Name (Legal Business Name): ULTIMATE THINKING PSYCHOLOGICAL CONSULTANTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2009
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 BUSINESS CENTER DR STE A
ORMOND BEACH FL
32174-6631
US

IV. Provider business mailing address

PO BOX 730434
ORMOND BEACH FL
32173-0434
US

V. Phone/Fax

Practice location:
  • Phone: 386-243-5228
  • Fax: 877-601-7246
Mailing address:
  • Phone: 386-243-5228
  • Fax: 877-601-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY 7888
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. XUAN STEVENS
Title or Position: PRESIDENT
Credential: PHD
Phone: 386-243-5228