DAVID C BLACKMON,PHD,PSYCH SVC (NPI# 1538438270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538438270 |
| Entity Type | Organization |
| Organization Name | DAVID C BLACKMON,PHD,PSYCH SVC |
| Practice Address |
482 Jacksonville Dr Jacksonville Beach FL 32250-3812 |
| Practice Telephone | 9043333389 |
| Practice Fax Number | 9042466703 |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2012-01-03 |
| Authorized Official Name | DR. DAVID C BLACKMON (PRESIDENT) |
| Authorized Official Telephone | 9043333389 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY4360 | FL | Behavioral Health & Social Service Providers |
| Street Address |
482 JACKSONVILLE DR |
| City | JACKSONVILLE BEACH |
| State | FL |
| Zip Code | 32250-3812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326156423 | James Fletcher | Psychologist | 482 Jacksonville Dr, Jacksonville Beach, FL 32250-3812 | 2006-08-28 |
| 1255664348 | Steven L. Wise | Psychologist | 482 Jacksonville Dr, Jacksonville Beach, FL 32250-3812 | 2009-09-08 |
| 1396855961 | Mercedes Mcgowan | Psychologist | 482 Jacksonville Dr, Jacksonville Beach, FL 32250-3812 | 2006-08-30 |
| 1780792762 | Carl Burak | Specialist | 482 Jacksonville Dr, Jacksonville Beach, FL 32250-3812 | 2006-08-29 |
| 1487762639 | Deborah Hardman | Counselor | 482 Jacksonville Dr, Jacksonville Beach, FL 32250-3812 | 2006-08-28 |
| 1295843464 | Ronnie Burak | Psychologist | 482 Jacksonville Dr, Jacksonville Beach, FL 32250-3812 | 2006-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386129591 | Kelsey Ilene Keimig | Audiologist | 3200 S 3rd Street, Ste 101, Jacksonville, FL 32250 | 2018-10-03 |
| 1225529696 | Turning Tides Eating Disorder Treatment Center, LLC. | Clinic/Center | 4300 Marsh Landings Blvd. #101, Jacksonville Beach, FL 32250 | 2018-05-22 |
| 1528578820 | Dianne Frances Gay | Dental Hygienist | 1144 14th Street North, Jacksonville Beach, FL 32250 | 2017-10-02 |
| 1801324280 | Kailo Nutrition | Dietitian, Registered | 353 B 6th Street South, Jacksonville, FL 32250 | 2017-05-30 |
| 1275985368 | Shankeertha Sundaralingam | Dentist | 3316 3rd St S Ste 101, Jacksonville Beach, FL 32250 | 2016-07-13 |
| 1851777494 | Brooke Worthington Davidson | Audiologist | 1370 13th Ave S Ste 115, Jacksonville Beach, FL 32250 | 2015-08-05 |
| 1689059115 | Jenna Levine | Speech-Language Pathologist | 779 10th Avenue South, Jacksonville Beach, FL 32250 | 2015-07-27 |
| 1790176824 | Olivia Ingram Caswell | Acupuncturist | 2902 Isabella Boulevard, Suite 50, Jacksonville Beach, FL 32250 | 2015-02-11 |
| 1467859033 | Colleen Freeman | Physical Therapist | 1537 Penman Rd, Jacksonville, FL 32250 | 2014-11-26 |
| 1356750012 | Madelyn Jones | Physical Therapist | 1320 Roberts Drive, Jacksonville Beach, FL 32250 | 2014-08-07 |
| Find all providers in zip 32250 | ||||
| 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 |
|---|---|---|---|---|
| 1912512831 | Joshua Rooks, Phd, LLC | Clinical Neuropsychologist | 7328 Jacaranda Ln, Miami Lakes, FL 33014-2670 | 2020-09-09 |
| 1457978991 | Renew Psychiatric Care, LLC | Clinical Neuropsychologist | 3170 N Federal Hwy Ste 206b, Lighthouse Point, FL 33064-6720 | 2020-07-01 |
| 1871110460 | Thoughtwise LLC | Clinical Neuropsychologist | 2840 Remington Green Cir Ste 3, Tallahassee, FL 32308-1518 | 2020-06-29 |
| 1093338451 | Krizia Amy Vinck | Clinical Neuropsychologist | 1150 Nw 14th St, Miami, Fl 33136, Miami, FL 33136 | 2020-05-20 |
| 1124667795 | Jennifer Ann Barton | Clinical Neuropsychologist | 3411 Day Ave, Miami, FL 33133-5030 | 2019-12-31 |
| 1952947434 | Dagmar E Nunez | Clinical Neuropsychologist | 1351 Seagrape Cir, Weston, FL 33326-2726 | 2019-11-20 |
| 1821632779 | Joshua Daniel Rooks | Clinical Neuropsychologist | 6520 Miami Lakeway S, Miami Lakes, FL 33014-2747 | 2019-11-04 |
| 1427605088 | Global Wellness LLC | Clinical Neuropsychologist | 1560 Sawgrass Corporate Parkway #447, Sunrise, FL 33323 | 2019-08-19 |
| 1528627882 | Anchor Multispecialty Group | Clinical Neuropsychologist | 850 S Palafox St Unit 103, Pensacola, FL 32502-5983 | 2019-06-11 |
| 1639736473 | Aldrich Chan | Clinical Neuropsychologist | 2601 Sw 37th Ave Ste 703, Coral Gables, FL 33133-2750 | 2019-05-28 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE BEACH |
| Zip Code | 32250 |
Please comment or provide details below to improve the information on DAVID C BLACKMON,PHD,PSYCH SVC.
| 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.