- Medicare Mental Health Clinic in Jacksonville, FL

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is a medicare enrolled mental health clinic (General Practice) in Jacksonville, Florida. The current practice location for is 4655 Salisbury Rd Ste 220, Jacksonville, Florida. For appointments, you can reach them via phone at (904) 570-9404. The mailing address for is 4655 Salisbury Rd Ste 110, Jacksonville, Florida and phone number is (904) 733-1003.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1174112007. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (904) 570-9404.

Contact Information

4655 Salisbury Rd Ste 220
Jacksonville
FL 32256-0959
(904) 570-9404
(904) 900-2224

Map and Direction


Mental Health Clinic Profile

Full Name
SpecialityGeneral Practice
Location4655 Salisbury Rd Ste 220, Jacksonville, Florida
Authorized Official Name and PositionRobert G Young (SECRETARY & CAO)
Authorized Official Contact9047331003
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

4655 Salisbury Rd Ste 110
Jacksonville
FL 32256-0957

Ph: (904) 733-1003
4655 Salisbury Rd Ste 220
Jacksonville
FL 32256-0959

Ph: (904) 570-9404

NPI Details:

NPI Number1174112007
Provider Enumeration Date01/14/2021
Last Update Date12/27/2023
Certification Date12/27/2023

Medicare PECOS Information:

Medicare PECOS PAC ID3779991542
Medicare Enrollment IDO20210415000680

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174112007NPI-NPPES
10D2178878OtherFLCLIA
12550OtherFLAHCA
110526700MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health (* (Not Available))Secondary
208D00000XGeneral Practice (* (Not Available))Primary
363LP0808XNurse Practitioner - Psychiatric/mental Health (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameJulie Tutak Maly
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972536514
PECOS PAC ID: 3072414077
Enrollment ID: I20040114000053
Provider NameRenee O Slabicki
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710085402
PECOS PAC ID: 9931202801
Enrollment ID: I20070314000082
Provider NameMichael A Edwards
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437355302
PECOS PAC ID: 6406911486
Enrollment ID: I20090209000423
Provider NameMichael Tracy
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1124054945
PECOS PAC ID: 0042359507
Enrollment ID: I20091123000651
Provider NameSean F Mcgrath
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1588624803
PECOS PAC ID: 8820137029
Enrollment ID: I20091201000488
Provider NameNina E D'andrea
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134462989
PECOS PAC ID: 0941441810
Enrollment ID: I20130719000243
Provider NamePatricia D Seemann
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912301029
PECOS PAC ID: 4981826880
Enrollment ID: I20141110000373
Provider NameDawn R Dust
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730562760
PECOS PAC ID: 5991012213
Enrollment ID: I20150919000140
Provider NameTiffany Leanne Mcclain
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740658954
PECOS PAC ID: 4486954211
Enrollment ID: I20151201002081
Provider NameDonna J Cothren
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255703302
PECOS PAC ID: 0840592028
Enrollment ID: I20160105001498
Provider NameShannon C Orlando
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003326463
PECOS PAC ID: 8527328657
Enrollment ID: I20180208002665
Provider NameAleisha Michelle Gasaway
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861976789
PECOS PAC ID: 1850637497
Enrollment ID: I20190118000061
Provider NameMonet Jeniece Scott
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053808360
PECOS PAC ID: 9234478611
Enrollment ID: I20190301000371
Provider NameErika Favors Nisbett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891250486
PECOS PAC ID: 7214277417
Enrollment ID: I20190326002302
Provider NameVanessa Izquierdo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841848835
PECOS PAC ID: 6002147824
Enrollment ID: I20191009001966
Provider NameJamie Lea Laakmann
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801449624
PECOS PAC ID: 7416389838
Enrollment ID: I20191122001275
Provider NameMichael Joseph Conigliaro
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205483898
PECOS PAC ID: 0749613172
Enrollment ID: I20191125002862
Provider NameJessica Danielle Tomko
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538792858
PECOS PAC ID: 3274962444
Enrollment ID: I20200409001374
Provider NameAmy Algood
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629626718
PECOS PAC ID: 6507278942
Enrollment ID: I20201209001597
Provider NameBrittany Cabler
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366039208
PECOS PAC ID: 8022423227
Enrollment ID: I20210222001433
Provider NameBrandi Polite
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699447078
PECOS PAC ID: 2860883642
Enrollment ID: I20220105001958
Provider NameKimberly Ann Robbins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083374888
PECOS PAC ID: 2163814781
Enrollment ID: I20220111002309
Provider NameTasha Ellsberry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013466697
PECOS PAC ID: 5698168375
Enrollment ID: I20220201000857
Provider NameElisabeth Francis Harris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659032118
PECOS PAC ID: 3476946641
Enrollment ID: I20220210001911
Provider NameDeena Marie Lowery
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104570092
PECOS PAC ID: 0042606196
Enrollment ID: I20220330000231
Provider NameAlecksandra Pantoja
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609508027
PECOS PAC ID: 2062894421
Enrollment ID: I20220801002847
Provider NameColleen M Ware
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295462083
PECOS PAC ID: 7911381421
Enrollment ID: I20220901001954
Provider NameSheila Mfuru
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386372068
PECOS PAC ID: 8022493386
Enrollment ID: I20220922001755
Provider NameMatthew Hurst
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962138594
PECOS PAC ID: 3870979032
Enrollment ID: I20220926003194
Provider NameJasmine S Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629799101
PECOS PAC ID: 4587040167
Enrollment ID: I20221005001234
Provider NameShannon Williams
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548917537
PECOS PAC ID: 1456727429
Enrollment ID: I20221015000140
Provider NameNancy Haake Walter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093438152
PECOS PAC ID: 4981070323
Enrollment ID: I20221026001341
Provider NameAmorie Brooke Wright
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558099150
PECOS PAC ID: 3072981190
Enrollment ID: I20221122000700
Provider NameNatasha King
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982327896
PECOS PAC ID: 8921477688
Enrollment ID: I20221220000954
Provider NameAnna Cushman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285332338
PECOS PAC ID: 7315311123
Enrollment ID: I20230317002004
Provider NameHope Wilson Arcuri
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477250348
PECOS PAC ID: 6800260290
Enrollment ID: I20230327001672
Provider NameJacquelyn Hill
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013522473
PECOS PAC ID: 3173998812
Enrollment ID: I20230411000183
Provider NameCyndia Milord-giordani
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598486912
PECOS PAC ID: 6305202862
Enrollment ID: I20230525002252
Provider NameRobert Allen Roscoe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518645969
PECOS PAC ID: 1254792690
Enrollment ID: I20230801002139
Provider NameYurgita Vaidya
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578346318
PECOS PAC ID: 5799132098
Enrollment ID: I20231108001128
Provider NameBernitta Colley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255113346
PECOS PAC ID: 3173974995
Enrollment ID: I20240105002408
Provider NameElina Chernyak
Provider TypePractitioner - Addiction Medicine
Provider IdentifiersNPI Number: 1710110820
PECOS PAC ID: 4082877899
Enrollment ID: I20240319004169
Provider NameRuth Janice Gimenez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104695071
PECOS PAC ID: 3072950591
Enrollment ID: I20240320001083
Provider NameHannah Hendershot
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780446815
PECOS PAC ID: 4082056676
Enrollment ID: I20240529000082
Provider NameSharon Brandt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134988330
PECOS PAC ID: 8921544800
Enrollment ID: I20240727000024
Provider NameKelli Meeks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255172870
PECOS PAC ID: 1850723602
Enrollment ID: I20240806004778
Provider NameMary Sarfo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386494185
PECOS PAC ID: 4082154133
Enrollment ID: I20240904003331
Provider NameRobin Ringer
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1659130839
PECOS PAC ID: 8022558386
Enrollment ID: I20240912003581
Provider NameDeborah Gibson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851121461
PECOS PAC ID: 3779023049
Enrollment ID: I20240912003978
Provider NameDanielle Dodd
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851135776
PECOS PAC ID: 6608302229
Enrollment ID: I20241206000048
Provider NameValerie Cruz-polanco
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770303794
PECOS PAC ID: 4688100068
Enrollment ID: I20241209002612

Reviews and Comments

General Practice in Jacksonville, FL

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    

Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 4131 University Blvd S Ste 10, Jacksonville, FL 32216
Phone: 508-769-2707    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.