| Entity Name: | FAMILY PSYCHOLOGY ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 Dec 1991 (33 years ago) |
| Document Number: | V00591 |
| FEI/EIN Number | 593097140 |
| Address: | 801 2ND ST. N., SUITE 7, SAFETY HARBOR, FL, 34695, US |
| Mail Address: | 801 2ND ST. N., SUITE 7, SAFETY HARBOR, FL, 34695, US |
| ZIP code: | 34695 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598801110 | 2007-01-30 | 2008-03-07 | 801 2ND ST N STE 7, SAFETY HARBOR, FL, 346953503, US | 801 2ND ST N STE 7, SAFETY HARBOR, FL, 346953503, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-725-8820 |
Authorized person
| Name | DR. MICHAEL T SMITH |
| Role | OWNER |
| Phone | 7277258820 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103TA0700X - Adult Development & Aging Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TB0200X - Cognitive & Behavioral Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TC1900X - Counseling Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TF0000X - Family Psychologist |
| Is Primary | Yes |
| Taxonomy Code | 103TP2701X - Group Psychotherapy Psychologist |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
Other Provider Identifiers
| Issuer | AMERIGROUP GROUP NUMBER |
| Number | 229318 |
| State | FL |
| Issuer | BCBS GROUP |
| Number | 99280 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GEORGE JEFFREY MPSY.D | Agent | 801 2ND ST. N., SAFETY HARBOR, FL, 34695 |
| Name | Role | Address |
|---|---|---|
| SMITH MICHAEL T | Director | 1640 PARILLA CIRCLE, NEW PORT RICHEY, FL, 34655 |
| GEORGE JEFFREY P | Director | 1604 COUNRTY TRAILS DRIVE, SAFETY HARBOR, FL, 34695 |
| Peal Geoffrey T | Director | 1833 Elaine Dr, Clearwater, FL, 33760 |
| Snyder Benjamin | Director | 3339 Coontie Ct, Trinity, FL, 34655 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
