| Baptist Behavioral Health, Llc | |
|
841 Prudential Dr Fl 10 Jacksonville FL 32207-8329 | |
| (904) 376-3800 | |
| (904) 396-8975 |
| Full Name | Baptist Behavioral Health, Llc |
|---|---|
| Speciality | Counselor |
| Location | 841 Prudential Dr Fl 10, Jacksonville, Florida |
| Authorized Official Name and Position | Terrie Andrews (ADMINISTRATOR) |
| Authorized Official Contact | 9043763800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baptist Behavioral Health, Llc Po Box 748519 Atlanta GA 30374-8519 Ph: (904) 376-3800 | Baptist Behavioral Health, Llc 841 Prudential Dr Fl 10 Jacksonville FL 32207-8329 Ph: (904) 376-3800 |
| NPI Number | 1215906649 |
|---|---|
| Provider Enumeration Date | 03/17/2006 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Medicare PECOS PAC ID | 7315166394 |
|---|---|
| Medicare Enrollment ID | O20140924001767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215906649 | NPI | - | NPPES |
| 007AM | Other | FL | BCBS OF FLORIDA |
| 8205120 | Other | FL | AETNA |
| 015645200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Daphne Denise Coats |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235330549 PECOS PAC ID: 9335234764 Enrollment ID: I20071001000490 |
| Provider Name | Sarah S Drew |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457417164 PECOS PAC ID: 8224125414 Enrollment ID: I20071105000441 |
| Provider Name | Elizabeth Tannahill Glen Keymer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336256353 PECOS PAC ID: 3072687649 Enrollment ID: I20080730000407 |
| Provider Name | Cathleen Connolly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437307956 PECOS PAC ID: 5294895322 Enrollment ID: I20081119000797 |
| Provider Name | Raymond M Pomm |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659541654 PECOS PAC ID: 2365590833 Enrollment ID: I20090512000033 |
| Provider Name | Rose Marie Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447294079 PECOS PAC ID: 4486705985 Enrollment ID: I20090623000621 |
| Provider Name | Karla Repper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720216369 PECOS PAC ID: 5193866283 Enrollment ID: I20100127000566 |
| Provider Name | Susan M Archacki-resnik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821258484 PECOS PAC ID: 1456495241 Enrollment ID: I20100217000333 |
| Provider Name | Donald Pollock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114947074 PECOS PAC ID: 8224172457 Enrollment ID: I20100225000445 |
| Provider Name | Patricia Phd Leavy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750482337 PECOS PAC ID: 7416087663 Enrollment ID: I20100614000871 |
| Provider Name | Julie K Kuhns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538486782 PECOS PAC ID: 7315070661 Enrollment ID: I20100806000359 |
| Provider Name | Stephanie V Sims |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790954774 PECOS PAC ID: 0042403560 Enrollment ID: I20101018000046 |
| Provider Name | Janice Pimentel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689970261 PECOS PAC ID: 0941484612 Enrollment ID: I20110405000853 |
| Provider Name | Karen S Mcneely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285778423 PECOS PAC ID: 8325216211 Enrollment ID: I20110720000340 |
| Provider Name | Saneha R Goyal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770740136 PECOS PAC ID: 2365617966 Enrollment ID: I20111209000386 |
| Provider Name | Anjali A Pathak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558448928 PECOS PAC ID: 5890757793 Enrollment ID: I20120314000120 |
| Provider Name | John Byron |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023038072 PECOS PAC ID: 1355538034 Enrollment ID: I20120517000223 |
| Provider Name | Joann Hoza |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558428813 PECOS PAC ID: 3274781828 Enrollment ID: I20120924000640 |
| Provider Name | Rachael Sanchez |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1790915064 PECOS PAC ID: 6608028634 Enrollment ID: I20121220000127 |
| Provider Name | Karina A Jeifez Zagagi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639440415 PECOS PAC ID: 5496990608 Enrollment ID: I20130318000099 |
| Provider Name | Kristen M Kelley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154483956 PECOS PAC ID: 1355580176 Enrollment ID: I20130626000589 |
| Provider Name | Anneline Kingsley |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1609134816 PECOS PAC ID: 2365686193 Enrollment ID: I20130918000432 |
| Provider Name | Shariq Refai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467680660 PECOS PAC ID: 7618111477 Enrollment ID: I20131008001134 |
| Provider Name | Karen Sandbach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083846414 PECOS PAC ID: 8224265855 Enrollment ID: I20131205001398 |
| Provider Name | Amelia D Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316297054 PECOS PAC ID: 6709017759 Enrollment ID: I20140317000425 |
| Provider Name | Stephanie B.h. Kinnare |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841637428 PECOS PAC ID: 7315179363 Enrollment ID: I20140407000904 |
| Provider Name | Sara Bertoch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033461611 PECOS PAC ID: 4880812650 Enrollment ID: I20140820002306 |
| Provider Name | Sarah Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023425287 PECOS PAC ID: 7315167210 Enrollment ID: I20140926001805 |
| Provider Name | Candice M Franco |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992114318 PECOS PAC ID: 2860613288 Enrollment ID: I20141028000262 |
| Provider Name | Henry Donald Benson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275931339 PECOS PAC ID: 6709101082 Enrollment ID: I20150209000023 |
| Provider Name | Julia Garrett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316282593 PECOS PAC ID: 2567778368 Enrollment ID: I20150824002192 |
| Provider Name | Katie Mahon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164846960 PECOS PAC ID: 3476861840 Enrollment ID: I20151005001157 |
| Provider Name | Gregory Devon Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427317825 PECOS PAC ID: 9335366186 Enrollment ID: I20160629000056 |
| Provider Name | Sierra Dawn Trainor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386194512 PECOS PAC ID: 4082994520 Enrollment ID: I20161129002145 |
| Provider Name | Nicole Winter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578007118 PECOS PAC ID: 5092098970 Enrollment ID: I20170220002655 |
| Provider Name | Lisa L Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356433429 PECOS PAC ID: 7517934581 Enrollment ID: I20170719004028 |
| Provider Name | Lauren Elizabeth Tressler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144743337 PECOS PAC ID: 1850666421 Enrollment ID: I20171006002293 |
| Provider Name | Janette Thames |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023537602 PECOS PAC ID: 6002172293 Enrollment ID: I20171103000651 |
| Provider Name | Marek Hirsch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295167385 PECOS PAC ID: 6204126873 Enrollment ID: I20180116001174 |
| Provider Name | Devon Patterson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326567587 PECOS PAC ID: 3274892419 Enrollment ID: I20180117000697 |
| Provider Name | Leslie A Barstow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578093142 PECOS PAC ID: 7911267331 Enrollment ID: I20180205000014 |
| Provider Name | Jusleen C Kendhari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548490527 PECOS PAC ID: 7911124573 Enrollment ID: I20180307000153 |
| Provider Name | Lindsay Mckim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801297049 PECOS PAC ID: 5395007769 Enrollment ID: I20180322002570 |
| Provider Name | Jennifer Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245640614 PECOS PAC ID: 9739307836 Enrollment ID: I20180709002138 |
| Provider Name | Tahra Sealy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427547348 PECOS PAC ID: 8527319045 Enrollment ID: I20180924000333 |
| Provider Name | Coral Gaffney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457786915 PECOS PAC ID: 8729331889 Enrollment ID: I20181019001532 |
| Provider Name | Alice Trice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780160309 PECOS PAC ID: 9638423643 Enrollment ID: I20181109002142 |
| Provider Name | Donna Ray Iverson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346725025 PECOS PAC ID: 4789689589 Enrollment ID: I20181204001122 |
| Provider Name | Jennifer Ortiz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235490491 PECOS PAC ID: 3678817160 Enrollment ID: I20181211001292 |
| Provider Name | Cheryl Anne Dietly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649758756 PECOS PAC ID: 9436494507 Enrollment ID: I20181218000778 |
| Provider Name | Megan Lynn Mccurdy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649787623 PECOS PAC ID: 2668714320 Enrollment ID: I20190429001386 |
| Provider Name | Christopher Rackley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093939498 PECOS PAC ID: 1557652401 Enrollment ID: I20190806001101 |
| Provider Name | Richelle Alyssa Ricer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215589551 PECOS PAC ID: 8224367115 Enrollment ID: I20190830001917 |
| Provider Name | Danella Denise Mcintyre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659864528 PECOS PAC ID: 4486983095 Enrollment ID: I20190906002609 |
| Provider Name | Andrew Brown King |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164079554 PECOS PAC ID: 1850621608 Enrollment ID: I20190923000664 |
| Provider Name | Rebecca Jean Penna |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346599701 PECOS PAC ID: 5193056273 Enrollment ID: I20191004001192 |
| Provider Name | Maria H Anastasiades |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740752435 PECOS PAC ID: 6406187004 Enrollment ID: I20191014000257 |
| Provider Name | Adeline Leon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477103539 PECOS PAC ID: 4981935301 Enrollment ID: I20191015002851 |
| Provider Name | Brooke Bien-coatney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356692263 PECOS PAC ID: 5890027759 Enrollment ID: I20191024003208 |
| Provider Name | Miguel A Franco |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669015111 PECOS PAC ID: 5698108876 Enrollment ID: I20191202000498 |
| Provider Name | Stefanie Andrea Paliatsos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821221615 PECOS PAC ID: 7315292190 Enrollment ID: I20200110000320 |
| Provider Name | Michael Alexander Slifer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821359597 PECOS PAC ID: 1254766512 Enrollment ID: I20200114001547 |
| Provider Name | Savitha Puttaiah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255594032 PECOS PAC ID: 0345406799 Enrollment ID: I20200224001675 |
| Provider Name | Holly Redlinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801243985 PECOS PAC ID: 6901236140 Enrollment ID: I20200430001666 |
| Provider Name | Aylin Oya Emmert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003200247 PECOS PAC ID: 5991012759 Enrollment ID: I20200630003162 |
| Provider Name | Jonathan D Browning |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740636307 PECOS PAC ID: 3678860665 Enrollment ID: I20200709002482 |
| Provider Name | Kristen Galloway |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477832715 PECOS PAC ID: 5294168498 Enrollment ID: I20200713000383 |
| Provider Name | Amy Michelle Brannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306463914 PECOS PAC ID: 7618390253 Enrollment ID: I20200715000113 |
| Provider Name | Blazen Draguljic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528249125 PECOS PAC ID: 0941574362 Enrollment ID: I20200715003076 |
| Provider Name | Ajla Hurem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104442953 PECOS PAC ID: 8325462047 Enrollment ID: I20200728000422 |
| Provider Name | Sevdalina M Dabova-missova |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1104831072 PECOS PAC ID: 5799753315 Enrollment ID: I20200910001532 |
| Provider Name | Eralene Spoelhof |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720691843 PECOS PAC ID: 2961821244 Enrollment ID: I20201006002365 |
| Provider Name | Aubrey Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811598295 PECOS PAC ID: 8527478338 Enrollment ID: I20201106000876 |
| Provider Name | Elizabeth Bateh Engel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548857154 PECOS PAC ID: 4789097700 Enrollment ID: I20210113000592 |
| Provider Name | Kimberly J Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902428568 PECOS PAC ID: 1557775749 Enrollment ID: I20210129000897 |
| Provider Name | Christina Mccullough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548695877 PECOS PAC ID: 5294140026 Enrollment ID: I20210209000620 |
| Provider Name | Christine Crews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053807750 PECOS PAC ID: 3678811387 Enrollment ID: I20210212000425 |
| Provider Name | Gina Malejko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174062962 PECOS PAC ID: 4486922978 Enrollment ID: I20210218001069 |
| Provider Name | Justine Pigott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548634868 PECOS PAC ID: 7719394204 Enrollment ID: I20210330000620 |
| Provider Name | Alicia Elisa Ayala Laconich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376138495 PECOS PAC ID: 0244648731 Enrollment ID: I20210422000553 |
| Provider Name | Michael J. De La Hunt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811002892 PECOS PAC ID: 3274942883 Enrollment ID: I20210512001337 |
| Provider Name | Joshua Proemsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760837363 PECOS PAC ID: 3173810397 Enrollment ID: I20210614002582 |
| Provider Name | Audrey Pulitzer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760910798 PECOS PAC ID: 3971905456 Enrollment ID: I20210706003034 |
| Provider Name | Carolyn Therese Coppedge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417542333 PECOS PAC ID: 3779989389 Enrollment ID: I20210907003634 |
| Provider Name | Danielle M Newsholme |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174291645 PECOS PAC ID: 1557767902 Enrollment ID: I20210909002263 |
| Provider Name | Matthew E Harnach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447607486 PECOS PAC ID: 9032406798 Enrollment ID: I20210913001277 |
| Provider Name | Christopher Holcomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639711716 PECOS PAC ID: 8628405768 Enrollment ID: I20210915001945 |
| Provider Name | Rita Thanga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508480229 PECOS PAC ID: 0648678326 Enrollment ID: I20211011001288 |
| Provider Name | Gerilyn C Worthy-thayer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073977849 PECOS PAC ID: 8022406404 Enrollment ID: I20211104001409 |
| Provider Name | Hazem Herbly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346200540 PECOS PAC ID: 9931598299 Enrollment ID: I20211109000192 |
| Provider Name | Tracy Lynn Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295064129 PECOS PAC ID: 3971992199 Enrollment ID: I20211109003555 |
| Provider Name | Meaghan Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033878533 PECOS PAC ID: 0547653438 Enrollment ID: I20220217002196 |
| Provider Name | Hidi Mcchesney Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194482489 PECOS PAC ID: 4880089416 Enrollment ID: I20220317002780 |
| Provider Name | Jacob Andrew Heislman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457009920 PECOS PAC ID: 1456746593 Enrollment ID: I20220328000923 |
| Provider Name | Joseph Sesta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568513992 PECOS PAC ID: 1759769953 Enrollment ID: I20220531001621 |
| Provider Name | Amber Lynn Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043535677 PECOS PAC ID: 6406078708 Enrollment ID: I20220603001316 |
| Provider Name | Daniel Antonio Franco |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528523420 PECOS PAC ID: 3274863659 Enrollment ID: I20220708000921 |
| Provider Name | Stacey Lynn Delanoit |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821437443 PECOS PAC ID: 9133555725 Enrollment ID: I20220830002824 |
| Provider Name | Stanley Traylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740777143 PECOS PAC ID: 8921357518 Enrollment ID: I20220907001468 |
| Provider Name | Chelsea Taylor Moon-tison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073274403 PECOS PAC ID: 1658756838 Enrollment ID: I20220924000285 |
| Provider Name | Jason Lulejian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245643048 PECOS PAC ID: 8426395062 Enrollment ID: I20221003000986 |
| Provider Name | Dallas James Webb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720709314 PECOS PAC ID: 6002292422 Enrollment ID: I20221007001046 |
| Provider Name | Ovidiu Gabriel Cruceru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669105672 PECOS PAC ID: 5799151908 Enrollment ID: I20221012004128 |
| Provider Name | Catherine M Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144953324 PECOS PAC ID: 2961878921 Enrollment ID: I20221014002762 |
| Provider Name | Amanda Durden Quintana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932869559 PECOS PAC ID: 5698141661 Enrollment ID: I20221017000029 |
| Provider Name | Lauren Lynn Papalas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821758731 PECOS PAC ID: 5597131458 Enrollment ID: I20221018000423 |
| Provider Name | Amanda Marie Massman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578920864 PECOS PAC ID: 0446627517 Enrollment ID: I20221102000428 |
| Provider Name | Kelsey L. Bloom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730892365 PECOS PAC ID: 5799155792 Enrollment ID: I20230109002373 |
| Provider Name | Sarah Madison Garrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427729938 PECOS PAC ID: 0143692194 Enrollment ID: I20230221001152 |
| Provider Name | Amanda Lucinda Glynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982301784 PECOS PAC ID: 6305210188 Enrollment ID: I20230317000618 |
| Provider Name | Jaime K Martino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528553393 PECOS PAC ID: 6103178611 Enrollment ID: I20230725002948 |
| Provider Name | Anastasia Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245789478 PECOS PAC ID: 4385004944 Enrollment ID: I20230804003419 |
| Provider Name | Rene Alejandro Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447944921 PECOS PAC ID: 9032571252 Enrollment ID: I20230818002216 |
| Provider Name | Jessica Renee Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093498016 PECOS PAC ID: 1850754995 Enrollment ID: I20230823000281 |
| Provider Name | Veronika Roza Vozniak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962958538 PECOS PAC ID: 7517238926 Enrollment ID: I20230825000697 |
| Provider Name | Chloe Marlies Birch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164203337 PECOS PAC ID: 7315393675 Enrollment ID: I20231024001227 |
| Provider Name | Jennifer Michelle Branscome |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790240984 PECOS PAC ID: 1759737380 Enrollment ID: I20231102000466 |
| Provider Name | Blake Forrest Klepal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639684681 PECOS PAC ID: 0941657183 Enrollment ID: I20231109003310 |
| Provider Name | Kelly Lynn Shurman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255585857 PECOS PAC ID: 5092162933 Enrollment ID: I20231114001909 |
| Provider Name | Vivian Louise Pinner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831466945 PECOS PAC ID: 2466809314 Enrollment ID: I20231114002378 |
| Provider Name | Dorie Elizabeth Hanson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740655018 PECOS PAC ID: 7719334416 Enrollment ID: I20231116001678 |
| Provider Name | Meghan Jeffrey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710553334 PECOS PAC ID: 3173970878 Enrollment ID: I20231116001696 |
| Provider Name | Marianna Ioanni Georgiadou |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306237649 PECOS PAC ID: 9032566732 Enrollment ID: I20231116001887 |
| Provider Name | Michelle Kebby Leon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164084505 PECOS PAC ID: 8729435425 Enrollment ID: I20231116002023 |
| Provider Name | Michael Anthony Valdez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528333200 PECOS PAC ID: 3274980974 Enrollment ID: I20231116002046 |
| Provider Name | Emily A Durik |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679821326 PECOS PAC ID: 2365899077 Enrollment ID: I20231116002082 |
| Provider Name | Tiarik Sims |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558069567 PECOS PAC ID: 4486001195 Enrollment ID: I20231116002528 |
| Provider Name | Sheena Etienne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548520075 PECOS PAC ID: 1557718277 Enrollment ID: I20231116002627 |
| Provider Name | Tyrenia Octavia Cross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184018665 PECOS PAC ID: 1254788904 Enrollment ID: I20231117000323 |
| Provider Name | Janet Alexandra Dobson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619667144 PECOS PAC ID: 7315394061 Enrollment ID: I20231117000428 |
| Provider Name | Vicki Vaughn Vangundy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376009522 PECOS PAC ID: 6507213261 Enrollment ID: I20231117000782 |
| Provider Name | Michelle Lee Piesbergen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205359924 PECOS PAC ID: 4880041565 Enrollment ID: I20231117001216 |
| Provider Name | Kendra Anne Wagner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366138406 PECOS PAC ID: 0840647525 Enrollment ID: I20231117001329 |
| Provider Name | Stephanie Ann Mullis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831226323 PECOS PAC ID: 9931557659 Enrollment ID: I20231118000370 |
| Provider Name | Wendy Ann Sheroke-hughes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366858375 PECOS PAC ID: 9931557667 Enrollment ID: I20231118000419 |
| Provider Name | Katrina N Morgan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013416890 PECOS PAC ID: 7214385970 Enrollment ID: I20231120000762 |
| Provider Name | Harry Warner Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831413236 PECOS PAC ID: 8325496938 Enrollment ID: I20231120003614 |
| Provider Name | Tarmattie M Singh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861981003 PECOS PAC ID: 8325429269 Enrollment ID: I20231122001865 |
| Provider Name | Summer Rae Scott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023410156 PECOS PAC ID: 2769830009 Enrollment ID: I20231128001793 |
| Provider Name | Kara Anglin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912662875 PECOS PAC ID: 8527416668 Enrollment ID: I20231129002574 |
| Provider Name | Marcie Thomas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265084115 PECOS PAC ID: 1153779228 Enrollment ID: I20231129003886 |
| Provider Name | Amanda Glunz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1740735695 PECOS PAC ID: 6305294497 Enrollment ID: I20231130000441 |
| Provider Name | Meagan Charice Brown |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881071496 PECOS PAC ID: 9133577257 Enrollment ID: I20231130001616 |
| Provider Name | Jessica Beel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710231063 PECOS PAC ID: 2860840824 Enrollment ID: I20231130003973 |
| Provider Name | Linda Gamble Spadaro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447400627 PECOS PAC ID: 2860840840 Enrollment ID: I20231201000259 |
| Provider Name | Kanaklakshmi Masodkar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164860748 PECOS PAC ID: 6002114345 Enrollment ID: I20231205003434 |
| Provider Name | Ember Leipert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962861286 PECOS PAC ID: 2769831593 Enrollment ID: I20231205003983 |
| Provider Name | Nancy Elaine Hucker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336383983 PECOS PAC ID: 5597114009 Enrollment ID: I20231209000120 |
| Provider Name | Michele Malnove |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306502109 PECOS PAC ID: 3173972619 Enrollment ID: I20231211000175 |
| Provider Name | Pia Maria Ristaino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164605572 PECOS PAC ID: 3476902610 Enrollment ID: I20231213000553 |
| Provider Name | Carol A Visconti |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285868141 PECOS PAC ID: 4981054863 Enrollment ID: I20231219002969 |
| Provider Name | Sia Ngauja |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528648672 PECOS PAC ID: 2466802681 Enrollment ID: I20231229000640 |
| Provider Name | Lee Ann Annotti |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114354586 PECOS PAC ID: 6406280627 Enrollment ID: I20231229000799 |
| Provider Name | Dzenefa Ramic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811462237 PECOS PAC ID: 6103277611 Enrollment ID: I20240109004048 |
| Provider Name | Cecelia Anne Bushery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841897642 PECOS PAC ID: 8224489752 Enrollment ID: I20240109004674 |
| Provider Name | Anna-leigh Powell Robison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316612641 PECOS PAC ID: 6305236555 Enrollment ID: I20240125000211 |
| Provider Name | Shawanda Holloway |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285074203 PECOS PAC ID: 6204289598 Enrollment ID: I20240202002187 |
| Provider Name | Kristin Nichole Le |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447713490 PECOS PAC ID: 4385986801 Enrollment ID: I20240325000898 |
| Provider Name | Deidra D Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821867425 PECOS PAC ID: 6406295047 Enrollment ID: I20240416002509 |
| Provider Name | Rhiannon Doherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295073542 PECOS PAC ID: 2466696067 Enrollment ID: I20240520001442 |
| Provider Name | Melissa Nelsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003659848 PECOS PAC ID: 0042756413 Enrollment ID: I20240722001808 |
| Provider Name | Yevgeniya Nikolayeva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467294512 PECOS PAC ID: 7214474824 Enrollment ID: I20240731004343 |
| Provider Name | Yolanda Blount |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073984746 PECOS PAC ID: 5698212769 Enrollment ID: I20240807001104 |
| Provider Name | Michelle Jenice Mcgriff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083489009 PECOS PAC ID: 9830636794 Enrollment ID: I20240808004772 |
| Provider Name | Victoria Alyssa Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417424227 PECOS PAC ID: 5193262053 Enrollment ID: I20240808004850 |
| Provider Name | Jennifer Lynn Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437834280 PECOS PAC ID: 1658819297 Enrollment ID: I20240814003300 |
| Provider Name | John Richard Crossfield |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043293111 PECOS PAC ID: 2668911009 Enrollment ID: I20240828005287 |
| Provider Name | Kayla Marie Woodle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538650973 PECOS PAC ID: 6709325962 Enrollment ID: I20240831000611 |
| Provider Name | Robert Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750307427 PECOS PAC ID: 4385817378 Enrollment ID: I20240908000105 |
| Provider Name | Shannon Elisabeth Kerecman-silvestri |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700399532 PECOS PAC ID: 8628518297 Enrollment ID: I20240910001747 |
| Provider Name | Sidney Anne Vernon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447843735 PECOS PAC ID: 4789124272 Enrollment ID: I20240911001770 |
| Provider Name | James G Solari |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245850908 PECOS PAC ID: 7911448006 Enrollment ID: I20240917000560 |
| Provider Name | Le Andrea Banks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326276312 PECOS PAC ID: 5092852665 Enrollment ID: I20241025002374 |
| Provider Name | Chandra Y Hicks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386023950 PECOS PAC ID: 3274961313 Enrollment ID: I20241122004195 |
Mark Dearing,lcsw Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12412 San Jose Blvd Ste 401, Jacksonville, FL 32223 Phone: 904-348-0343 | |
Reconnect Consulting Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3955 Riverside Ave, Jacksonville, FL 32205 Phone: 904-483-3843 | |
South Rehabilitation Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 580 Ellis Rd S, Suite 118, Jacksonville, FL 32254 Phone: 904-423-0017 Fax: 904-683-8169 | |
Mtb Therapist, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6034 Chester Ave, Jacksonville, FL 32217 Phone: 904-323-2019 | |
Mc Medical Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12100 Lem Turner Rd Unit 100, Jacksonville, FL 32218 Phone: 904-764-2855 Fax: 904-764-2670 | |
Westland Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6196 Lake Gray Blvd, Jacksonville, FL 32244 Phone: 718-483-5093 | |