BRENNA SQUIRES (PSY.D.) – Clinical Psychologist, NPI 1104177732
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
667 CLINICAL PSYCHOLOGIST in VA
Provider Addresses for BRENNA SQUIRES (PSY.D.)
4522 W VILLAGE DR # 513
TAMPA, FL 336243429
Phone:
Type: Mailing
2202 EXECUTIVE DR
HAMPTON, VA 236666604
Phone: (757) 827-7707
Type: Location
63 MICHAELS WOODS DR
HAMPTON, VA 236665613
Phone:
Type: Mailing
5301 N FEDERAL HWY STE 270
BOCA RATON, FL 334874910
Phone: (561) 241-6628
Type: Location
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: 2022-09-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220919000686 | I | Clinical Psychologist | FL | TBD |
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.
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 33624)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | FL | |
| Psychiatry, Geriatric Psychiatry | FL | |
| Clinical Psychologist | FL | |
| Mental Health Counselor | FL | |
| Clinical Social Worker | FL | |
| Clinical Social Worker | FL | |
| Clinical Social Worker | FL | |
| Marriage And Family Therapist | FL | |
| Psychiatry, Addiction Medicine | FL | |
| Mental Health Counselor | FL |
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