BAPTIST BEHAVIORAL HEALTH, LLC (NPI# 1215906649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215906649 |
| Entity Type | Organization |
| Organization Name | BAPTIST BEHAVIORAL HEALTH, LLC |
| Practice Address |
841 Prudential Dr Fl 10 Jacksonville FL 32207-8329 |
| Mailing Address |
Po Box 44230 Jacksonville FL 32231-4230 |
| Practice Telephone | 9043763800 |
| Practice Fax Number | 9043968975 |
| Mailing Telephone | 9043763800 |
| Mailing Fax Number | 9043763998 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2018-03-29 |
| Authorized Official Name | DR. TERRIE ANDREWS (ADMINISTRATOR) |
| Authorized Official Telephone | 9043763800 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 015645200 | 05 | |
| FL | BCBS OF FLORIDA | 007AM | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1235 San Marco Blvd Ste 3, Jacksonville, FL 322078582 | 9043763800 | 9043968978 |
| 1650 Prudential Dr Ste 210, Jacksonville, FL 322078149 | 9043763800 | 9043964942 |
| 1747 Baptist Clay Dr Ste 350, Fleming Island, FL 320038504 | 9043763800 | 9043968977 |
| 820 Prudential Dr Ste 510, Jacksonville, FL 322078207 | 9043763800 | 9042022436 |
| 810 Lane Ave S, Jacksonville, FL 322054785 | 9043763800 | 9043968976 |
| 13241 Bartram Park Blvd Unit 1901, Jacksonville, FL 322585228 | 9043763800 | 9043968967 |
| 836 Prudential Dr Ste 1107, Jacksonville, FL 322078338 | 9043763800 | 9043968970 |
| 9090 Regency Square Blvd, Jacksonville, FL 322118119 | 9043763800 | 9043968974 |
| 841 Prudential Dr Ste 180, Jacksonville, FL 322078350 | 9043763800 | 9043968973 |
| 87010 Professional Way, Yulee, FL 320973400 | 9043763800 | 9043968969 |
| 900 Beach Blvd Ste 930, Jacksonville Beach, FL 322504368 | 9043763800 | 9043968968 |
| 524 Skymarks Dr Unit 5, Jacksonville, FL 322187254 | 9043763800 | 9043968966 |
| Street Address |
841 PRUDENTIAL DR FL 10 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669015111 | Miguel A Franco | Psychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2019-10-28 |
| 1477103539 | Adeline Leon | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2019-09-19 |
| 1023537602 | Janette Thames | Psychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2017-09-14 |
| 1275931339 | Henry Benson | Psychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2014-12-05 |
| 1487072245 | Omar Jishi Moore | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2014-03-30 |
| 1780008425 | Daniel Howard Olsen | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2014-02-18 |
| 1255694667 | Scott M Dellorso | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2012-06-20 |
| 1083846414 | Karen Cooper Sandbach | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2009-08-18 |
| 1427205038 | Jason Shaun Day | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Credentialing Department, Jacksonville, FL 32207-8329 | 2008-08-26 |
| 1528229184 | Georgia Gianakakos | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Credentialing Department, Jacksonville, FL 32207-8329 | 2008-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248112 | Timothy Scott Mccann | Counselor | 7400 San Jose Blvd, Jacksonville, FL 32217-3430 | 2020-09-08 |
| 1831700848 | Anil Suthar | Counselor | 11776 Wattle Tree Rd N, Jacksonville, FL 32246-9751 | 2020-08-12 |
| 1700496494 | Debra Jones Lewis | Counselor | 2416 Christi Lakes Ct, Jacksonville, FL 32221-3891 | 2020-08-06 |
| 1992356117 | Nicole Wojcik | Counselor | 221 New Bridge St, Jacksonville, NC 28540-4736 | 2019-09-28 |
| 1700435401 | Lori Svendsen Brown | Counselor | 824 Gum Branch Rd Ste 0, Jacksonville, NC 28540-6272 | 2019-09-05 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1700356367 | Ajay S Lewis | Counselor | 3010 Cobblewood Ln East, Jacksonville, FL 32225 | 2018-11-27 |
| 1144708157 | Anastasia Marie Judge-arauz | Counselor | 187 Howard Rd, Jacksonville, NC 28540-9332 | 2018-08-01 |
| 1720593072 | Cherae Miles | Counselor | 862 Bunker Hill Blvd, Jacksonville, FL 32208-3220 | 2017-12-08 |
| 1083127476 | Heather Watkins | Counselor | 113 Philip St, Jacksonville, TX 75766-3781 | 2017-11-08 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on BAPTIST BEHAVIORAL HEALTH, LLC.
| 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.