=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730496308
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARRIE SPRINGER, PH.D., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2010
-----------------------------------------------------
Last Update Date | 09/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3005 LITHIA PINECREST RD
-----------------------------------------------------
City | VALRICO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33596-5630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-704-6668
-----------------------------------------------------
Fax | 813-425-5739
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3005 LITHIA PINECREST RD
-----------------------------------------------------
City | VALRICO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33596-5630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-704-6668
-----------------------------------------------------
Fax | 813-425-5739
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/PSYCHOLOGIST
-----------------------------------------------------
Name | DR. CARRIE ANN SPRINGER
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 941-704-6668
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | PY6536
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------