MRS. MAVIS BENNETT (NPI# 1003999608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003999608 |
| Entity Type | Individual |
| Full Name | MRS. MAVIS BENNETT |
| Credential | PSYCHOLOGIST |
| Practice Address |
1100 S Ponce De Leon Blvd Ste 1 St Augustine FL 32084-6013 |
| Practice Telephone | 9048247733 |
| Practice Fax Number | 9048299768 |
| Mailing Telephone | 9048247733 |
| Mailing Fax Number | 9048299768 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103T00000X | Psychologist | MT1268 | FL | Behavioral Health & Social Service Providers |
| X | 103TC1900X |
Psychologist Specialization: Counseling |
MT1268 | FL | Behavioral Health & Social Service Providers |
| Street Address |
1100 S PONCE DE LEON BLVD STE 1 |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32084-6013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215260609 | Patricia Lewis-slayton, Lcsw Lmft. Inc | Social Worker | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084-6013 | 2009-09-16 |
| 1033364971 | Mary Alston Kerllenevich, LLC | Psychologist | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084-6013 | 2008-11-19 |
| 1922299809 | Kathleen Ann Myers | Social Worker | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084-6013 | 2007-08-06 |
| 1952451775 | Psychological Services of St. Augustine | Counselor | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084-6013 | 2007-01-12 |
| 1386713048 | Mary Alston Kerllenevich | Psychologist | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084-6013 | 2006-11-07 |
| 1588733323 | Isobel J Mcgrath | Counselor | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084-6013 | 2006-11-07 |
| 1245309210 | David O'byrne | Counselor | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084-6013 | 2006-11-06 |
| 1437232295 | Valerie Lynne Bartol | Counselor | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084-6013 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347599 | Cody Martyn | Pharmacist | 955 Fl-16, St. Augustine, FL 32084 | 2020-08-18 |
| 1912562471 | Kjcares Suportive Living Services | Case Manager/Care Coordinator | 20 First Street, Apt 5, St. Augustine, FL 32084 | 2019-05-09 |
| 1558841684 | Kevin D Roberts | Psychologist | 20 First Street Apt 5, St. Augustine, FL 32084 | 2018-08-17 |
| 1568954576 | Gwendolyn Marie Spong | Nurse Practitioner | 2703 N Ponce De Leon Blvd., Minute Clinic #3591, Area 4, Region 46, St. Augustine, FL 32084 | 2018-06-05 |
| 1770940116 | Marian L. Turner-sharpton, Lcsw | Social Worker | 17 Pacific St., Suite 2 (growth Pointe), St. Augustine, FL 32084 | 2016-01-15 |
| 1710358932 | Florida Laboratory Analysis, LLC | Clinical Medical Laboratory | 1690 Us Highway 1 S Ste D, St Augustine, FL 32084 | 2015-10-14 |
| 1780064774 | J Mae Transportation | Non-emergency Medical Transport (VAN) | 28 N Whitney St Apt 404, St Augustine, FL 32084 | 2015-06-04 |
| 1497154520 | Suzanne Smith Weed | Nurse Practitioner | 32 Mulberry Street, Saint Augustine, FL 32084 | 2014-08-14 |
| 1447684469 | Rachel Moran | Counselor | 162 Oneida Street, St. Augustine, FL 32084 | 2013-08-27 |
| 1932545993 | Matrix Medical, LLC | Durable Medical Equipment & Medical Supplies | 56 S Dixie Hwy Ste 1, St Augustine, FL 32084 | 2013-05-17 |
| Find all providers in zip 32084 | ||||
| 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 |
|---|---|---|---|---|
| 1316112709 | Mgw Inc | Psychologist | 350 Paseo Reyes Dr, St Augustine, FL 32095-8464 | 2008-04-25 |
| 1609070069 | Kenneth Dillon Robertson | Psychologist | 3604 Fort Peyton Cir, St Augustine, FL 32086-9101 | 2007-06-12 |
| 1548380686 | Paul L. Martin Jr. | Psychologist | 2200 N Ponce De Leon Blvd Ste 3, St Augustine, FL 32084-2650 | 2007-03-30 |
| 1528086329 | S Graham Kosch | Psychologist | 100 S Ponce De Leon Blvd, Suite 1, St Augustine, FL 32084-4214 | 2006-07-18 |
| 1154394088 | Janet R. Mullins | Psychologist | 24 Cathedral Pl Ste 407, St Augustine, FL 32084-4460 | 2006-02-10 |
| 1407390529 | Nakisha Marie Carrasquillo-richardson | Psychologist | 1301 Plantation Island Dr S, Ste. 201 A, St Augustine, FL 32080-3108 | 2016-12-08 |
| 1811385636 | Marti Mason | Psychologist | 155 San Marco Ave, St Augustine, FL 32084-3268 | 2014-12-31 |
| 1184857187 | Lynn M. Helder, Ph.d., P.a. | Psychologist | 1201 Arapaho Ave, St Augustine, FL 32084-4203 | 2009-08-25 |
| 1811128622 | Louis R. Franzini | Psychologist | 350 Paseo Reyes Dr, St Augustine, FL 32095-8464 | 2009-07-29 |
| 1033364971 | Mary Alston Kerllenevich, LLC | Psychologist | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084-6013 | 2008-11-19 |
| Find all providers in ST AUGUSTINE | ||||
| City | ST AUGUSTINE |
| Zip Code | 32084 |
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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.