Provider Demographics
NPI:1558258756
Name:PROFITT, DENNIS NEIL (PHD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:NEIL
Last Name:PROFITT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16251 YGNACIO SERRA DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-8365
Mailing Address - Country:US
Mailing Address - Phone:812-239-4643
Mailing Address - Fax:812-239-4643
Practice Address - Street 1:110 RABY AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32509-5124
Practice Address - Country:US
Practice Address - Phone:850-457-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041991A103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling