DR FAIRALL AND ASSOCIATES BEHAVIORAL HEALTH AND FAMILY MEDIATION SERVI (NPI# 1083088165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083088165 |
| Entity Type | Organization |
| Organization Name | DR FAIRALL AND ASSOCIATES BEHAVIORAL HEALTH AND FAMILY MEDIATION SERVI |
| Practice Address |
4400 Marsh Landing Blvd Suite 1 Ponte Vedra Beach FL 32082-7215 |
| Mailing Address |
117 Old Mill Ct Ponte Vedra Beach FL 32082-4133 |
| Practice Telephone | 9044632284 |
| Mailing Telephone | 9044632284 |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |
| Authorized Official Name | DR. LAURIE FAIRALL (OWNER) |
| Authorized Official Telephone | 9044632284 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PY 7675 | FL | Behavioral Health & Social Service Providers |
| Street Address |
4400 MARSH LANDING BLVD SUITE 1 |
| City | PONTE VEDRA BEACH |
| State | FL |
| Zip Code | 32082-7215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922052257 | David Meriwether Harvey | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-7215 | 2006-05-20 |
| 1669795761 | Dr. Laurie Fairall-rueter, LLC | Psychologist | 4400 Marsh Landing Blvd, Suite 1, Ponte Vedra Beach, FL 32082-1287 | 2010-03-04 |
| 1174783161 | David M Harvey Phd P A | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-7215 | 2008-06-12 |
| 1265539555 | Jane Young Hill | Social Worker | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-1287 | 2006-09-20 |
| 1336250083 | James November | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-1287 | 2006-08-31 |
| 1487768248 | Laurie S. Fairall-rueter | Psychologist | 4400 Marsh Landing Blvd, Suite 1, Ponte Vedra Beach, FL 32082-1287 | 2006-08-18 |
| 1912989658 | Joan Simon | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-7215 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576818 | Specialty Eye Surgeons, Pa | Ophthalmology | 240 Ponte Vedra Boulevard, Suite 202, Ponte Vedra Beach, FL 32082 | 2020-07-23 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1568988129 | Mustafa Bakir | General Practice | 1102 A1a, Ponte Vedra Beach, FL 32082 | 2017-08-16 |
| 1457890584 | Angelyn Sorgen | Nurse Practitioner | 1102 Hwy A1a, Suite 104, Ponte Vedra Beach, FL 32082 | 2017-02-22 |
| 1033575121 | Balanced Physician Care Pa | Family Medicine | 115 Professional Park Drive, Suite 104, Ponte Vedra Beach, FL 32082 | 2016-01-06 |
| 1528436060 | Robert Thompson II | Chiropractor | 135 Professional Drive, Suite 105, Ponte Vedra Beach, FL 32082 | 2015-09-14 |
| 1144628439 | Integrative Medical Group, Usa, LLC | Clinic/Center | 1102 A1a North, Suite 104, Ponte Vedra Beach, FL 32082 | 2014-12-18 |
| 1811308901 | Janice Wachtel, Phd, LLC | Psychologist | 100 Executive Way, Suite 110, Ponte Vedra Beach, FL 32082 | 2014-05-12 |
| 1578991154 | Nicole Theiler | Counselor | 171 Canal Blvd, Ponte Vedra Beach, FL 32082 | 2013-10-17 |
| 1982948006 | Daisamma Varghese | Nurse Practitioner | 860 A1an, Ponte Vedra, FL 32082 | 2012-11-15 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831365154 | Keystone Behavioral Pediatrics, LLC | Psychologist | 172 Canal Blvd, Ponte Vedra Beach, FL 32082-3606 | 2008-05-06 |
| 1760451637 | Gregory Lee Garamoni | Psychologist | 2304 Sawgrass Village Dr, Ponte Vedra Beach, FL 32082-5007 | 2006-03-14 |
| 1497262620 | Mandala Family Wellness LLC | Psychologist | 171 Canal Blvd, Ponte Vedra Beach, FL 32082-3607 | 2018-01-09 |
| 1336250083 | James November | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-1287 | 2006-08-31 |
| 1487768248 | Laurie S. Fairall-rueter | Psychologist | 4400 Marsh Landing Blvd, Suite 1, Ponte Vedra Beach, FL 32082-1287 | 2006-08-18 |
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|---|---|---|---|---|
| 1376144774 | Jennifer Mcmanus | Psychologist | 4143 San Juan Ave, Jacksonville, FL 32210-3333 | 2020-11-03 |
| 1992304711 | Thomas Francis Ryan | Psychologist | 1015 Sonesta Ave, Brandon, FL 33511-6658 | 2020-10-22 |
| 1912506924 | Emily F. Hoon, Phd, Pllc | Psychologist | 2531 Nw 41st Street, Suite C, Gainesville, FL 32606-7490 | 2020-10-21 |
| 1447866405 | Daniel Martinez | Psychologist | 4765 W Atlantic Ave, Delray Beach, FL 33445-3838 | 2020-09-16 |
| 1134731367 | North Florida Neuropsychology, LLC | Psychologist | 1614 Mahan Center Blvd Ste 104, Tallahassee, FL 32308-5475 | 2020-08-19 |
| 1215547153 | Ellen Frances Price Phd | Psychologist | 7025 Beracasa Way Ste 102c, Boca Raton, FL 33433-3428 | 2020-08-05 |
| 1811515745 | Sarah Amelia Sanon | Psychologist | 10381 Sw 9th Ln, Pembroke Pines, FL 33025-3585 | 2020-07-07 |
| 1720606718 | Carolina Montalvo | Psychologist | 480 Ne 30th St Apt 1606, Miami, FL 33137-4337 | 2020-07-07 |
| 1689291833 | Bridget Cabibi | Psychologist | 10700 Nw 66th St Apt 512, Doral, FL 33178-5508 | 2020-07-02 |
| 1912524414 | Infinity Doctors Inc. | Psychologist | 9821 E Bay Harbor Dr Apt 401, Bay Harbor Islands, FL 33154-1868 | 2020-06-30 |
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| City | PONTE VEDRA BEACH |
| Zip Code | 32082 |
Please comment or provide details below to improve the information on DR FAIRALL AND ASSOCIATES BEHAVIORAL HEALTH AND FAMILY MEDIATION SERVI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.