| Emery Milne Psychological Group, Llc | |
|
165 Wells Rd Ste 304 Orange Park FL 32073-3037 | |
| (904) 720-4040 | |
| (904) 720-4596 |
| Full Name | Emery Milne Psychological Group, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 165 Wells Rd Ste 304, Orange Park, Florida |
| Authorized Official Name and Position | Stephanie Milne (PSYCHOLOGIST/MANAGER) |
| Authorized Official Contact | 9042704040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emery Milne Psychological Group, Llc 165 Wells Rd Ste 304 Orange Park FL 32073-3037 Ph: (904) 720-4040 | Emery Milne Psychological Group, Llc 165 Wells Rd Ste 304 Orange Park FL 32073-3037 Ph: (904) 720-4040 |
| NPI Number | 1548741705 |
|---|---|
| Provider Enumeration Date | 08/27/2018 |
| Last Update Date | 01/24/2022 |
| Certification Date | 01/24/2022 |
| Medicare PECOS PAC ID | 1355695669 |
|---|---|
| Medicare Enrollment ID | O20181126000668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548741705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY9283 (Florida) | Primary |
| Provider Name | Stephanie M Milne |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659624609 PECOS PAC ID: 9638489693 Enrollment ID: I20151104001358 |
| Provider Name | Adeline Leon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477103539 PECOS PAC ID: 4981935301 Enrollment ID: I20191015002851 |
| Provider Name | Candice Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457738502 PECOS PAC ID: 6709258932 Enrollment ID: I20230215002628 |
| Provider Name | Melissa Monique Lawrence |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265849913 PECOS PAC ID: 1759739642 Enrollment ID: I20231204001307 |
| Provider Name | Vera Bowers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740650399 PECOS PAC ID: 0042669871 Enrollment ID: I20231205003951 |
| Provider Name | Darlene Sheefel Loveday |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598102402 PECOS PAC ID: 8729437843 Enrollment ID: I20231213004243 |
| Provider Name | Brian Emery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649643099 PECOS PAC ID: 1153772504 Enrollment ID: I20240110000935 |
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