PSI SERVICES III, INC. (NPI# 1306149844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306149844 |
| Entity Type | Organization |
| Organization Name | PSI SERVICES III, INC. |
| Other Organization Name | PSI FAMILY SERVICES, INC. |
| Practice Address |
3890 Dunn Ave Suite 1104 Jacksonville FL 32218-6428 |
| Mailing Address |
7101 Wisconsin Ave Suite 1400 Bethesda MD 20814-4871 |
| Practice Telephone | 9047236049 |
| Practice Fax Number | 9047235904 |
| Mailing Telephone | 3016543903 |
| Mailing Fax Number | 3016544418 |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2010-12-06 |
| Authorized Official Name | MR. RICKY WALLACE (CEO) |
| Authorized Official Telephone | 9047236049 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PSI Family Services, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942578133 | Psi Services IIi, Inc. | Clinic/Center | 770 M Street Se, Washington, DC 20003-3609 | 2011-12-02 |
| 1952452096 | Psi Services IIi, Inc. | Clinic/Center | 4819 Soutel Dr, Jacksonville, FL 32208-1856 | 2007-01-16 |
| 1114399862 | Psi Services IIi, Inc. | Clinic/Center | 5820 Dix St Ne, Washington, DC 20019-6965 | 2015-10-21 |
| 1013113554 | Psi Services IIi, Inc. | Day Training, Developmentally Disabled Services | 3890 Dunn Ave, Suite 1104, Jacksonville, FL 32218-6428 | 2007-06-22 |
| 1366653487 | Psi Services IIi, Inc. | Clinic/Center | 770 M St Se, Washington, DC 20003-3609 | 2007-05-24 |
| Street Address |
3890 DUNN AVE SUITE 1104 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-6428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174595318 | Tina Nannette Tillis | Ophthalmology | 3890 Dunn Ave, #902, Jacksonville, FL 32218-6428 | 2006-02-02 |
| 1083155725 | First Coast Cardiovascular | Internal Medicine | 3890 Dunn Ave, Ste 203, Jacksonville, FL 32218-6428 | 2017-03-14 |
| 1740631738 | Terra Harold Jackson | Social Worker | 3890 Dunn Ave, Suite 1104, Jacksonville, FL 32218-6428 | 2016-06-30 |
| 1467867168 | Tntmd Pa | Ophthalmology | 3890 Dunn Ave, Suite 902, Jacksonville, FL 32218-6428 | 2014-06-23 |
| 1639507254 | John Warren | Counselor | 3890 Dunn Ave, Jacksonville, FL 32218-6428 | 2013-10-16 |
| 1063847465 | Psi Behavioral Health LLC | Case Management | 3890 Dunn Ave, Suite 1104, Jacksonville, FL 32218-6428 | 2013-09-05 |
| 1124460738 | Psi Family Services | Community/Behavioral Health | 3890 Dunn Ave, Suite 1104, Jacksonville, FL 32218 | 2013-07-24 |
| 1154762284 | Psi Behavioral Health, LLC | Clinic/Center | 3890 Dunn Ave, Sutie 1104, Jacksonville, FL 32218-6428 | 2013-07-17 |
| 1326394792 | Veronica Thompson | Social Worker | 3890 Dunn Ave, Ste. 1104, Jacksonville, FL 32218-6428 | 2012-08-03 |
| 1922361732 | Psi Family Services, Inc. | Preferred Provider Organization | 3890 Dunn Ave, 1104, Jacksonville, FL 32218-6428 | 2012-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1386131092 | Renascence Behavioral Healthcare Group, Inc | Clinic/Center | 8553 Argyle Business Loop Ste 1, Jacksonville, FL 32244-6604 | 2018-04-18 |
| 1093231987 | Aspire Psychiatric Services, LLC | Clinic/Center | 625 N 1st St Ste C, Jacksonville, AR 72076-4138 | 2017-08-22 |
| 1598295701 | North Florida Learning & Behavioral Health, LLC | Clinic/Center | 8825 Perimeter Park Blvd Ste 302, Jacksonville, FL 32216-1112 | 2017-06-20 |
| 1700179868 | Chemical Dependency Counseling, Inc. | Clinic/Center | 300 W Adams St Ste 240, Jacksonville, FL 32202-4365 | 2011-05-24 |
| 1952452096 | Psi Services IIi, Inc. | Clinic/Center | 4819 Soutel Dr, Jacksonville, FL 32208-1856 | 2007-01-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
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| 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.