| Psychological Services Of St. Augustine | |
|
1100 S Ponce De Leon Blvd Ste 1 St Augustine FL 32084-6013 | |
| (904) 824-7733 | |
| Not Available |
| Full Name | Psychological Services Of St. Augustine |
|---|---|
| Speciality | Psychologist - Forensic |
| Location | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, Florida |
| Authorized Official Name and Position | Jack Merwin (OWNER) |
| Authorized Official Contact | 9048247733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Services Of St. Augustine 1100-1 South Ponce De Leon Blvd. St. Augustine FL 32084 Ph: (904) 824-7733 | Psychological Services Of St. Augustine 1100 S Ponce De Leon Blvd Ste 1 St Augustine FL 32084-6013 Ph: (904) 824-7733 |
| NPI Number | 1952451775 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952451775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PY2444 (Florida) | Primary |
| 103TF0200X | Psychologist - Forensic | PY2444 (Florida) | Primary |
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