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General NPI Number Information
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NPI Number | 1306133244
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Entity Type | Organization
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Legal Business Name | EXPERT PSYCHOLOGICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 447 NW PRIMA VISTA BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-8731
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Country | US
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Telephone | 772-249-2593
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Fax |
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Provider Business Mailing Address
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Address Line | 447 NW PRIMA VISTA BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-8731
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Country | US
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Telephone | 772-249-2593
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST/PRESIDENT
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Name | DR. GEORGE ZAKY
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Credential | PSY.D.
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Telephone | 772-249-2593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PY8016
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY8016
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License Number State | FL
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