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6950 Philips Hwy Suite11 Jacksonville FL 32216-6082 | |
| (904) 239-3677 | |
| (904) 866-4029 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 6950 Philips Hwy, Jacksonville, Florida |
| Authorized Official Name and Position | Andy A Gauler (MGR) |
| Authorized Official Contact | 9042393677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 54723 Jacksonville FL 32245-4723 Ph: (904) 270-9006 | 6950 Philips Hwy Suite11 Jacksonville FL 32216-6082 Ph: (904) 239-3677 |
| NPI Number | 1730405002 |
|---|---|
| Provider Enumeration Date | 04/12/2010 |
| Last Update Date | 12/11/2023 |
| Certification Date | 12/11/2023 |
| Medicare PECOS PAC ID | 6901046945 |
|---|---|
| Medicare Enrollment ID | O20130715000753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730405002 | NPI | - | NPPES |
| 016184300 | Medicaid | FL |
| Provider Name | Stephen L Curtis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447282025 PECOS PAC ID: 8022067578 Enrollment ID: I20050121000543 |
| Provider Name | Amie Berry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508194218 PECOS PAC ID: 0345384855 Enrollment ID: I20100317000710 |
| Provider Name | Patricia Hess |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669669826 PECOS PAC ID: 1153406517 Enrollment ID: I20110812000673 |
| Provider Name | Douglas C Gorospe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831129667 PECOS PAC ID: 4587837984 Enrollment ID: I20111031000586 |
| Provider Name | Michael Joseph Amiel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245254937 PECOS PAC ID: 1456515550 Enrollment ID: I20120620000578 |
| Provider Name | Lynne Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578999249 PECOS PAC ID: 9335373430 Enrollment ID: I20131003000116 |
| Provider Name | Lisa-mae S. Armbrust |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851662969 PECOS PAC ID: 2860786589 Enrollment ID: I20160803001696 |
| Provider Name | Susan W Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134664576 PECOS PAC ID: 4284917790 Enrollment ID: I20170207003034 |
| Provider Name | Fred Sacklow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619968716 PECOS PAC ID: 4981861002 Enrollment ID: I20180530003159 |
| Provider Name | Anton S Georgiev |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639841299 PECOS PAC ID: 3779972484 Enrollment ID: I20211118002708 |
| Provider Name | Sean P Meyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962804898 PECOS PAC ID: 2365890076 Enrollment ID: I20231117002867 |
| Provider Name | Shirley W King |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609511955 PECOS PAC ID: 0042668717 Enrollment ID: I20231120001180 |
| Provider Name | Andy Gauler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730492513 PECOS PAC ID: 3173763117 Enrollment ID: I20231129002267 |
| Provider Name | Melissa A Meyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790468015 PECOS PAC ID: 1557703766 Enrollment ID: I20240520002071 |
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