MEDICARE: HEALTHPSYCH ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY7812	FL

General Provider Information

NPI Number	:	1811367485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHPSYCH ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	695 CENTRAL AVE STE 105
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-3662
Country	:	US
Telephone Number	:	727-492-2693
Fax Number	:

Provider Business Practice Location Address
First Line	:	695 CENTRAL AVE STE 105
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-3662
Country	:	US
Telephone Number	:	727-492-2693
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST / PRESIDENT
Name	:	DR. JEREMY ZEHR
Credential	:	PSYD
Telephone Number	:	727-492-2693

Provider Enumeration Date	:	09/25/2015
Last Update Date	:	09/25/2015

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