CHRISTOPHER RACKLEY (NPI# 1093939498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093939498 |
Entity Type | Individual |
Full Name | CHRISTOPHER RACKLEY |
Credential | PSYD |
Practice Address |
1660 Prudential Dr Ste 210 Jacksonville FL 32207-8185 |
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 | 2007-04-13 |
Last Update Date | 2019-10-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | PY10506 | FL | Behavioral Health & Social Service Providers |
N | 103TC0700X |
Psychologist Specialization: Clinical |
PY10506 | FL | Behavioral Health & Social Service Providers |
N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
017020 | NY | Behavioral Health & Social Service Providers |
Street Address |
1660 PRUDENTIAL DR STE 210 |
City | JACKSONVILLE |
State | FL |
Zip Code | 32207-8185 |
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 | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447604806 | Rujvi Kamat | Clinical Neuropsychologist | 1235 San Marco Blvd Fl 4, Jacksonville, FL 32207-8554 | 2016-04-21 |
1750744405 | Andrew J Ruffett Phd LLC | Clinical Neuropsychologist | 11869 Curlew Way, Jacksonville, FL 32223-1939 | 2016-03-31 |
1629499819 | Bay Area Psychology Associates | Clinical Neuropsychologist | 302 Woodberry Pl, Jacksonville, NC 28540-4264 | 2013-12-14 |
1356778898 | Behavioral Health of North Florida Pllc | Clinical Neuropsychologist | 3733 University Blvd W Ste 214, Jacksonville, FL 32217-2128 | 2013-09-30 |
1336256353 | Elizabeth Tannahill Glen Keymer | Clinical Neuropsychologist | 751 Oak St Ste 120, Jacksonville, FL 32204-3359 | 2006-08-24 |
1215989991 | David S Sabsevitz | Clinical Neuropsychologist | 4500 San Pablo Rd S Dept Of, Jacksonville, FL 32224-1865 | 2006-05-17 |
1902880537 | Andrew J Ruffett | Clinical Neuropsychologist | 3617 Crown Point Rd, Ste 6, Jacksonville, FL 32257-9010 | 2005-12-06 |
1255331237 | Randi Most | Clinical Neuropsychologist | 13400 Sutton Park Dr S, Suite 1504, Jacksonville, FL 32224-0236 | 2005-07-30 |
1619973997 | Nicole Annette Hagedorn | Clinical Neuropsychologist | 2680 Henderson Dr Ste 5, Jacksonville, NC 28546-5297 | 2005-06-22 |
1477103539 | Adeline Leon | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2019-09-19 |
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.