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Psychiatry · Tallahassee, FL

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At a glance

1400 Village Square Blvd # 3-81835, Tallahassee, FL 32312-1250

NPPES record updated Mar 27, 2025. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

1400 Village Square Blvd # 3-81835
Tallahassee, FL 32312-1250

Additional reported practice locations

31331 Shadow Branch Ln
Spring, TX 773864611
Phone: 4079028899
Fax: 8009640791

Professional details: NPI, taxonomy & registry record

NPI1619591864

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Registry details

Primary taxonomy: Psychiatry
Taxonomy code: 2084P0800X
Enumeration date: Jun 3, 2020
Record updated: Mar 27, 2025

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Clinical Social Worker

1041C0700X

Emergency Medicine

207P00000X

Neurology

2084N0400X

Psychiatry

2084P0800X · Primary

Physician Assistant

363A00000X

Nurse Practitioner

363L00000X

Family Nurse Practitioner

363LF0000X

Specialty details in registry

363LP0808X

Specialty details in registry

364SP0808X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1400 Village Square Blvd # 3-81835
Tallahassee, FL 32312-1250

Phone: (407) 902-8899
Fax: (800) 964-0791

Mailing address

1400 VILLAGE SQUARE BLVD # 3-81835

TALLAHASSEE, FL 323121250

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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