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General NPI Number Information
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NPI Number | 1164899738
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Entity Type | Individual
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Provider Name | JEFFREY L PRZYBYSZ M.ED., PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2015
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 10000 BAY PINES BLVD
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City | BAY PINES
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State | FL
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Zip | 33744-8200
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Country | US
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Telephone | 277-425-1239
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Fax |
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Provider Business Mailing Address
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Address Line | 6151 107TH AVE N
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City | PINELLAS PARK
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State | FL
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Zip | 33782-2542
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Country | US
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Telephone | 440-521-6652
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS017943
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P.07600
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.0701156
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License Number State | OH
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