| First Coast Psychiatric Services, P.a. | |
|
1543 Kingsley Ave Ste 14 Orange Park FL 32073-4570 | |
| (904) 264-6977 | |
| (904) 269-0870 |
| Full Name | First Coast Psychiatric Services, P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1543 Kingsley Ave Ste 14, Orange Park, Florida |
| Authorized Official Name and Position | Heather Edwards (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 9042646977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Coast Psychiatric Services, P.a. 1543 Kingsley Ave Ste 14 Orange Park FL 32073-4570 Ph: (904) 264-6977 | First Coast Psychiatric Services, P.a. 1543 Kingsley Ave Ste 14 Orange Park FL 32073-4570 Ph: (904) 264-6977 |
| NPI Number | 1104222801 |
|---|---|
| Provider Enumeration Date | 11/07/2014 |
| Last Update Date | 01/28/2022 |
| Certification Date | 01/28/2022 |
| Medicare PECOS PAC ID | 9133441421 |
|---|---|
| Medicare Enrollment ID | O20141121001550 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104222801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME112832 (Florida) | Primary |
| Provider Name | Suhas V Joshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194747485 PECOS PAC ID: 3971520917 Enrollment ID: I20051028000304 |
| Provider Name | Kevin Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427184308 PECOS PAC ID: 6800972522 Enrollment ID: I20080320000592 |
| Provider Name | Carla A Schlenke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720101892 PECOS PAC ID: 7719018571 Enrollment ID: I20100623000769 |
| Provider Name | Julie A Cronauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871733642 PECOS PAC ID: 4082898663 Enrollment ID: I20110405001033 |
| Provider Name | Daphne T Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588686877 PECOS PAC ID: 7517130560 Enrollment ID: I20111108000121 |
| Provider Name | Ubaid A Khokhar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275713935 PECOS PAC ID: 9032291240 Enrollment ID: I20120824000633 |
| Provider Name | Andrew James Nagy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114470465 PECOS PAC ID: 3779866520 Enrollment ID: I20170202000044 |
| Provider Name | Katherine Black |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700342540 PECOS PAC ID: 5395084925 Enrollment ID: I20190226002975 |
| Provider Name | Sarah Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669013595 PECOS PAC ID: 4981936374 Enrollment ID: I20191105001187 |
| Provider Name | Zachary Larson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235895343 PECOS PAC ID: 8325490659 Enrollment ID: I20240122004605 |
| Provider Name | Cecelia Melissa Holtrop |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386322279 PECOS PAC ID: 4688026859 Enrollment ID: I20240123004905 |
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