BAPTIST BEHAVIORAL HEALTH, LLC
NPI 1164155974
Psychologist in Jacksonville, FL

Active since July 08, 2022
1650 PRUDENTIAL DR STE 210, JACKSONVILLE, FL 32207(904) 376-3800(904) 376-3998 Get Directions Write a Review

NPPES record last updated: July 8, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Baptist Behavioral Health, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAPTIST BEHAVIORAL HEALTH, LLC (NPI 1164155974) is a healthcare organization registered as a psychologist in Jacksonville, Florida and active in the NPI registry since July 2022. The organization lists Elizabeth Tish De Medici, Credentialing Mgr, as its authorized official.

NPPES Registry Identity

NPI1164155974
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameBAPTIST BEHAVIORAL HEALTH, LLC
Location Address1650 PRUDENTIAL DR STE 210Jacksonville, FL 32207-8149
Mailing AddressPo Box 748519Atlanta, GA 30374-8519 · (904) 376-3800 · Fax (904) 376-3998
Fax(904) 376-3998
Organization SubpartYes
Authorized OfficialElizabeth Tish De MediciCredentialing Mgr · (904) 376-3800
Enumeration DateJuly 8, 2022
NPPES CertifiedJune 28, 2022
NPI 1164155974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
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.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
1650 PRUDENTIAL DR STE 210, Jacksonville, FL 32207

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2308303

Baptist Behavioral Health, LLC · Jacksonville, FL
Expired · Jul 24, 2026
CLIA Number10D2308303
Laboratory TypePhysician Office
Certificate Effective DateJuly 25, 2024
Certificate Expiration DateJuly 24, 2026
Laboratory DirectorMarsell A. Brown
Laboratory Phone(904) 390-7401
Laboratory LocationBaptist Behavioral Health, LLC1660 Prudential Dr Suite 410, Southbank Plaza II,, Jacksonville, FL 32207
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Child & Adolescent Psychiatry)
1650 PRUDENTIAL DR STE 210
JACKSONVILLE, FL 32207
Clinical Neuropsychologist
1650 PRUDENTIAL DR STE 210
JACKSONVILLE, FL 32207
Marriage & Family Therapist
1650 PRUDENTIAL DR STE 210
JACKSONVILLE, FL 32207
Social Worker (Clinical)
1650 PRUDENTIAL DR STE 210
JACKSONVILLE, FL 32207
Counselor (Mental Health)
1650 PRUDENTIAL DR STE 210
JACKSONVILLE, FL 32207
Counselor (Mental Health)
1650 PRUDENTIAL DR STE 210
JACKSONVILLE, FL 32207
Social Worker (Clinical)
1650 PRUDENTIAL DR STE 210
JACKSONVILLE, FL 32207
Behavior Analyst
1650 PRUDENTIAL DR STE 210
JACKSONVILLE, FL 32207

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Baptist Behavioral Health, LLC's NPI number?

The NPI number for Baptist Behavioral Health, LLC is 1164155974. It was assigned to this organization in the NPPES registry on July 8, 2022.

Where is Baptist Behavioral Health, LLC located?

Baptist Behavioral Health, LLC is located at 1650 Prudential Dr Ste 210, Jacksonville, FL 32207. The listed phone number is (904) 376-3800.

What is Baptist Behavioral Health, LLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Baptist Behavioral Health, LLC was last updated on July 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.