CMS-1500 Box 24J / 33a • NPI
1073052205
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
103TC0700X (CMS 62)
Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical
Box 32 Service Location & ZIP+4
122 4TH AVE STE 200, INDIALANTIC, FL, 32903-3112
✓ 9-Digit EDI 837 ZIP+4 (32903-3112)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1073052205 (ARAGON PSYCHOLOGICAL SERVICES, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1073052205 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ARAGON PSYCHOLOGICAL SERVICES, LLC |
| Plain-English Specialty | Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical NUCC Code: 103TC0700X (Psychologist, Clinical) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 122 4TH AVE STE 200, INDIALANTIC, FL, 32903-3112 |
| Practice Telephone / Fax | Tel: (321) 327-3793 | Fax: (321) 327-7914 |
| Administrative Mailing Address | 3605 BURDOCK AVE, W MELBOURNE, FL, 32904-7526 |
| Enumeration & Last Sync | Enumerated: 2017-02-21 | CMS Record Updated: 2017-02-21 |
| Authorized Official | PATRICK ARAGON (Owner/ Clinical Psychologist) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (103TC0700X)
What Does Taxonomy Code 103TC0700X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TC0700X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ARAGON PSYCHOLOGICAL SERVICES, LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
103TC0700X — Psychologist, ClinicalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical | State: FL | License: PY9193 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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