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850 Nw Us Highway1 Ste 170 Stuart FL 34994-1019 | |
| (772) 485-7331 | |
| (561) 921-8790 |
| Full Name | |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 850 Nw Us Highway1 Ste 170, Stuart, Florida |
| Authorized Official Name and Position | Amber Deckard (NEUROPSYCOLOGIST/CEO) |
| Authorized Official Contact | 7729858394 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
850 Nw Us Highway1 Ste 170 Stuart FL 34994-1019 Ph: (772) 485-7331 | 850 Nw Us Highway1 Ste 170 Stuart FL 34994-1019 Ph: (772) 485-7331 |
| NPI Number | 1942039219 |
|---|---|
| Provider Enumeration Date | 07/26/2024 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Medicare PECOS PAC ID | 2163962150 |
|---|---|
| Medicare Enrollment ID | O20241018002843 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942039219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Frederick W Theye |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679537625 PECOS PAC ID: 2264405208 Enrollment ID: I20150129001368 |
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