MINDFUL FREEDOM PSYCHOLOGICAL SERVICES CORP
NPI 1225745425
Psychologist - Clinical in Jacksonville, FL

Q: What is Mindful Freedom Psychological Services Corp's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since October 28, 2022

2523 HERSCHEL ST, JACKSONVILLE, FL 32204(786) 868-7017 Get Directions Write a Review

NPPES record last updated: May 8, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 8, 2023, Oct 28, 2022 (2 updates tracked since 2022).

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About Mindful Freedom Psychological Services Corp NPPES

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

MINDFUL FREEDOM PSYCHOLOGICAL SERVICES CORP (NPI 1225745425) is a healthcare organization registered as a clinical in Jacksonville, Florida and active in the NPI registry since October 2022. The organization lists Laura Fernandez, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1225745425

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameMINDFUL FREEDOM PSYCHOLOGICAL SERVICES CORP

Location Address2523 HERSCHEL STJacksonville, FL 32204-4509

Mailing Address12418 Glenn Hollow DrJacksonville, FL 32226-2361 · (786) 868-7017

Phone(786) 868-7017

Organization SubpartNo

Authorized OfficialLaura FernandezOwner/provider · (786) 868-7017

Enumeration DateOctober 28, 2022

Last NPPES UpdateMay 8, 20232 updates tracked since enumeration

NPPES CertifiedMay 8, 2023

✔ NPI 1225745425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

2523 HERSCHEL ST, Jacksonville, FL 32204

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mindful Freedom Psychological Services Corp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Mindful Freedom Psychological Services Corp, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Laura Fernandez, PSY.D

Clinical Psychologist

NPI 1659880060

3 SHIRCLIFF WAY STE 601
Jacksonville, FL 32204

(786) 413-0336

✔ PECOS✔ Accepts Medicare1.0 mi

Nelsy Villalobos

Clinical Social Worker

NPI 1003575176

2574 COMMERCE PKWY
North Port, FL 34289

(941) 485-0121

✔ PECOS✔ Accepts Medicare224 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Mindful Freedom Psychological Services Corp's NPI number?

The NPI number for Mindful Freedom Psychological Services Corp is 1225745425. It was assigned to this organization in the NPPES registry on October 28, 2022.

Where is Mindful Freedom Psychological Services Corp located?

Mindful Freedom Psychological Services Corp is located at 2523 Herschel St, Jacksonville, FL 32204. The listed phone number is (786) 868-7017.

What is Mindful Freedom Psychological Services Corp's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mindful Freedom Psychological Services Corp enrolled in Medicare?

Yes. Mindful Freedom Psychological Services Corp is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mindful Freedom Psychological Services Corp?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Mindful Freedom Psychological Services Corp, in Clinical Psychologist and Clinical Social Worker. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mindful Freedom Psychological Services Corp accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Mindful Freedom Psychological Services Corp as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mindful Freedom Psychological Services Corp was last updated on May 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.