STEPHANIE BACKOF HOLMES KINNARE (NPI# 1841637428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841637428 |
| Entity Type | Individual |
| Full Name | STEPHANIE BACKOF HOLMES KINNARE |
| Other Name | STEPHANIE B HOLMES |
| Credential | PSYCHOLOGIST |
| Practice Address |
1650 Prudential Dr Ste 210 Jacksonville FL 32207 |
| Mailing Address |
Po Box 44230 Jacksonville FL 32231-4230 |
| Practice Telephone | 9043763800 |
| Practice Fax Number | 9043964942 |
| Mailing Telephone | 9043763800 |
| Mailing Fax Number | 9043763998 |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2018-05-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PY8730 | FL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6271 Saint Augustine Rd, Ufjax - Dept. of Pediatrics, Jacksonville, FL 322172523 | 9046330750 | 9046330751 |
| Street Address |
1650 PRUDENTIAL DR STE 210 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558428813 | Joann Hoza | Psychologist | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2007-01-03 |
| 1376009522 | Vicki Vaughn Vangundy | Counselor | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2019-02-13 |
| 1003200247 | Aylin Saner Emmert | Psychiatry & Neurology | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2015-03-25 |
| 1023425287 | Sarah Robinson | Psychologist | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2014-07-18 |
| 1578978342 | Jorge Andres Diaz | Psychiatry & Neurology | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2014-06-30 |
| 1295152510 | Shanique Ampiah | Psychiatry & Neurology | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2014-03-25 |
| 1447516802 | Rajiv Loungani | Psychiatry & Neurology | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2012-04-10 |
| 1720216369 | Karla Repper | Psychologist | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2009-06-22 |
| 1942353685 | Sheldon Jay Kaplan | Psychologist | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2007-01-18 |
| 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 | 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 |
| 1366724569 | Asa Therapeutic Services, Pllc | Psychologist | 200 Valencia Dr Ste 128, Jacksonville, NC 28546-6313 | 2011-09-13 |
| 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 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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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.