| Psychological Services Of Jacksonville Llc | |
|
358 Stiles Ave Suite B Orange Park FL 32073-4012 | |
| (904) 264-8311 | |
| (904) 264-8377 |
| Full Name | Psychological Services Of Jacksonville Llc |
|---|---|
| Speciality | Psychologist |
| Location | 358 Stiles Ave, Orange Park, Florida |
| Authorized Official Name and Position | Heather Kuiper (OFFICE MANAGER) |
| Authorized Official Contact | 9042648311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Services Of Jacksonville Llc 358 Stiles Ave Ste B Orange Park FL 32073-4012 Ph: (904) 264-8311 | Psychological Services Of Jacksonville Llc 358 Stiles Ave Suite B Orange Park FL 32073-4012 Ph: (904) 264-8311 |
| NPI Number | 1528005311 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 09/25/2025 |
| Certification Date | 09/25/2025 |
| Medicare PECOS PAC ID | 4880606987 |
|---|---|
| Medicare Enrollment ID | O20060607000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528005311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY-7122 (Florida) | Primary |
| Provider Name | Dawn K Fox |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982670774 PECOS PAC ID: 2062424161 Enrollment ID: I20060607000199 |
| Provider Name | Shelley Joy Rosen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598377822 PECOS PAC ID: 1254859028 Enrollment ID: I20250515001162 |
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