Dr Alicia Elisa Ayala Laconich, PHD IN PSYCHOLOGY is a medicare enrolled "Clinical Neuropsychologist" provider in Jacksonville, Florida. She graduated from medical school in 2015 and has 9 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice Baptist Behavioral Health Llc and her current practice location is
12574 Flagler Center Blvd, Ste 101, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at
(904) 374-4276.
Dr Alicia Elisa Ayala Laconich is licensed to practice in Florida (license number PY10781) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1376138495.
Healthcare Provider's Profile
| Full Name | Dr Alicia Elisa Ayala Laconich |
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| Gender | Female |
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| Speciality | Clinical Psychologist |
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| Experience | 9 Years |
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| Location | 12574 Flagler Center Blvd, Jacksonville, Florida |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Alicia Elisa Ayala Laconich graduated from medical school in 2015
NPI Data:
- NPI Number: 1376138495
- Provider Enumeration Date: 03/02/2021
- Last Update Date: 08/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 0244648731
- Enrollment ID: I20210422000553
Medical Identifiers
Medical identifiers for Dr Alicia Elisa Ayala Laconich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1376138495 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | PY10781 (Florida) | Secondary |
| 103G00000X | Clinical Neuropsychologist | PY10781 (Florida) | Primary |
Medical Facilities Affiliation
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Alicia Elisa Ayala Laconich allows following entities to bill medicare on her behalf.
| Entity Name | Baptist Behavioral Health Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1215906649
PECOS PAC ID: 7315166394
Enrollment ID: O20140924001767 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Alicia Elisa Ayala Laconich is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Alicia Elisa Ayala Laconich, PHD IN PSYCHOLOGY
12574 Flagler Center Blvd Ste 101,
Jacksonville, FL 32258-2615
Ph: () - | Dr Alicia Elisa Ayala Laconich, PHD IN PSYCHOLOGY
12574 Flagler Center Blvd, Ste 101,
Jacksonville, FL 32258-2615
Ph: (904) 374-4276 |
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