ASA THERAPEUTIC SERVICES, PLLC (NPI# 1366724569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366724569 |
| Entity Type | Organization |
| Organization Name | ASA THERAPEUTIC SERVICES, PLLC |
| Practice Address |
200 Valencia Dr Ste 128 Jacksonville NC 28546-6313 |
| Practice Telephone | 9109381300 |
| Practice Fax Number | 9109382900 |
| Mailing Telephone | 9109381300 |
| Mailing Fax Number | 9109382900 |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |
| Authorized Official Name | MRS. CHARMAINE DOWDELL (EXECUTIVE MANAGER) |
| Authorized Official Telephone | 9109381300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Street Address |
200 VALENCIA DR STE 128 |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| 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 |
|---|---|---|---|---|
| 1376144774 | Jennifer Mcmanus | Psychologist | 4143 San Juan Ave, Jacksonville, FL 32210-3333 | 2020-11-03 |
| 1952927600 | Lourdes Portales Dale | Psychologist | 580 W 8th St Fl Towerii6, Jacksonville, FL 32209-6533 | 2020-06-18 |
| 1114414992 | David Herbert Gilliland | Psychologist | 2752 Canyon Falls Dr, Jacksonville, FL 32224-4841 | 2018-04-17 |
| 1588903777 | Darrin John Kirkendall | Psychologist | 3901 University Blvd S Ste 203, Jacksonville, FL 32216-4389 | 2013-02-07 |
| 1851662969 | Lisa-mae Sinclair Armbrust | Psychologist | 11111 San Jose Blvd Ste 70, #185, Jacksonville, FL 32223-7274 | 2012-01-20 |
| 1164703047 | Aegis Psychological Consulting LLC | Psychologist | 208 E. Rusk St., Jacksonville, TX 75766 | 2011-09-06 |
| 1871872762 | Rebecca Tagg | Psychologist | 1179 Mccallister Rd, Jacksonville, NC 28540-8796 | 2011-08-09 |
| 1942597901 | Nancy Ghali | Psychologist | 4006 Henderson Dr., Jacksonville, NC 28546 | 2011-06-28 |
| 1457689911 | Leslie Herbert Krieger | Psychologist | 3834 Reedpond Dr S, Jacksonville, FL 32223-4820 | 2009-11-21 |
| 1245463090 | Lauren Brooke Yerkes | Psychologist | 1 Unf Dr, Counseling Center, Building 2, Room 2300, Jacksonville, FL 32224-7699 | 2009-08-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
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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.