DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.) – Clinical Psychologist, NPI 1083659445

DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.) is a healthcare provider. based in Ormond beach, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. 071006688 (IL). The NPI Number for DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.) is 1083659445

Main info

Female
Sole Proprietor
23 Years Of Experience
Accepts Medicare Assignment
Name
DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.)
NPI
1083659445
Phone
(773) 733-6629
Address
137 MILL SPRING PL
Enumeration Date
19 June 2006
Last Update Date
19 April 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7862690333
Graduation Year
2003 (23 years ago)
PAC ID
1456452770
Group Practice PAC ID
4486182342
Professional Enrollment ID
I20251002002225
Address ID
FL331314330MI201XXBLVD401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

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Provider Addresses for DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.)

  • 137, Mill Spring Place, Ormond Beach, Volusia County, Florida, 32174, United States

    ORMOND BEACH, FL 321744820

    Phone: (773) 733-6629

    Fax: (386) 463-2170

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251002002225IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32174)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486182342View full group profile
NameSpecialtyState
Clinical PsychologistCA
Clinical PsychologistMD
Clinical Social WorkerMD
Clinical PsychologistCO
Mental Health CounselorMD
Clinical PsychologistNY
Clinical PsychologistTN
Clinical PsychologistNC
Clinical PsychologistTX
Clinical Social WorkerMD

Reviews

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Frequently asked questions

What number should I use to identify DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.) for billing?
Administrative and clinical systems typically use NPI 1083659445 for DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.).
Should I treat DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.) as an active provider?
Patients and plans typically see DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.) as active in the national extract.
What type of care does DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.) provide?
DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.)'s profile centers on Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What city is tied to DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.)?
The directory associates DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.) with Ormond Beach, Florida. Check all listed addresses for suites or satellite offices.
Can I export DR. LAURIE ANN DECKARD-TANKERSLEY (PSY.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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