J NICHOLAS PREWETT PHD & ASSOCIATES PA (NPI# 1134276140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134276140 |
| Entity Type | Organization |
| Organization Name | J NICHOLAS PREWETT PHD & ASSOCIATES PA |
| Practice Address |
1726 Kingsley Ave Suite 12 Orange Park FL 32073-4463 |
| Practice Telephone | 9042696071 |
| Practice Fax Number | 9042696642 |
| Mailing Telephone | 9042696071 |
| Mailing Fax Number | 9042696642 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2008-03-24 |
| Authorized Official Name | JOHANN NICHOLAS PREWETT (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 9042696071 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
MH6231 | FL | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY4331 | FL | Behavioral Health & Social Service Providers |
| Street Address |
1726 KINGSLEY AVE SUITE 12 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154303410 | Susan M Shepherd | Social Worker | 1726 Kingsley Ave, Ste 3, Orange Park, FL 32073-4463 | 2005-11-14 |
| 1740892355 | Allison Tharaldsen | Case Manager/Care Coordinator | 1726 Kingsley Ave, Orange Park, FL 32073-4463 | 2020-08-17 |
| 1245662832 | Tia Wilson | Counselor | 1726 Kingsley Ave, Orange Park, FL 32073 | 2013-08-06 |
| 1376887315 | Ronny W Stephens | Counselor | 1726 Kingsley Ave, Suite 2, Orange Park, FL 32073-4463 | 2012-11-15 |
| 1427353150 | Janet M Grim Ma Lmft | Marriage & Family Therapist | 1726 Kingsley Ave, Suite 3, Orange Park, FL 32073 | 2011-01-11 |
| 1972539690 | Johann Nicholas Prewett | Psychologist | 1726 Kingsley Ave, Suite 12, Orange Park, FL 32073-4463 | 2006-06-24 |
| 1023090388 | Janet Mccullough Grim | Marriage & Family Therapist | 1726 Kingsley Ave, Suite 3, Orange Park, FL 32073 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659624609 | Stephanie Milne | Psychologist | 1734 Kingsley Ave Ste 2, Orange Park, FL 32073 | 2012-10-16 |
| 1467775379 | Janet Allison Anguas-keiter | Psychologist | 165 Wells Rd Ste 303, Orange Park, FL 32073-3036 | 2010-03-05 |
| 1700951688 | John R. Milligan | Psychologist | 2841 Circle Ridge Dr, Orange Park, FL 32065-5764 | 2006-11-23 |
| 1689779217 | Robin E O'hearn | Psychologist | 4605 Us Highway 17, Suite 2, Orange Park, FL 32003-7866 | 2006-09-14 |
| 1437251501 | Carole J Crane | Psychologist | 1680 Smith St, Suite 1, Orange Park, FL 32073-4852 | 2006-09-01 |
| 1982670774 | Dawn Kristine Fox | Psychologist | 358 Stiles Ave, Suite B, Orange Park, FL 32073-4012 | 2006-02-23 |
| 1609426352 | Jessica Bowden | Psychologist | 2300 Park Ave Ste 200, Orange Park, FL 32073-5571 | 2019-09-15 |
| 1548741705 | Emery Milne Psychological Group, LLC | Psychologist | 1734 Kingsley Ave Ste 2, Orange Park, FL 32073 | 2018-08-27 |
| 1467792697 | Dr Blake Bazel Phd Pa | Psychologist | 1677 Wells Rd, Suite A, Orange Park, FL 32073-6799 | 2013-02-25 |
| 1487904744 | Blake Bazel | Psychologist | 1677 Wells Rd, Suite A, Orange Park, FL 32073-6799 | 2012-09-14 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on J NICHOLAS PREWETT PHD & ASSOCIATES PA.
| 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.