DR. MARY ALSTON KERLLENEVICH PH.D.
NPI 1386713048
Psychologist in St Augustine, FL

Active since November 07, 2006PECOS Enrolled
1100 S PONCE DE LEON BLVD STE 1, ST AUGUSTINE, FL 32084(904) 824-7733(904) 829-9768 Get Directions Write a Review

NPPES record last updated: August 12, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mary Alston Kerllenevich Ph.d. NPPES

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

DR. MARY ALSTON KERLLENEVICH PH.D. (NPI 1386713048) is an individual psychologist in St Augustine, Florida, licensed in Florida (PY7744) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386713048
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. MARY ALSTON KERLLENEVICHCredential: PH.D.
Location Address1100 S PONCE DE LEON BLVD STE 1St Augustine, FL 32084-6013
Mailing Address1100 S Ponce De Leon Blvd Ste 1St Augustine, FL 32084-6013 · (904) 824-7733 · Fax (904) 829-9768
Fax(904) 829-9768
Sole ProprietorYes
Enumeration DateNovember 7, 2006
Last NPPES UpdateAugust 12, 2008
NPI 1386713048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in FL · PY7744
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 ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PY7744 (FL)
1100 S PONCE DE LEON BLVD STE 1, St Augustine, FL 32084

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Mary Alston Kerllenevich Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

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

Psychologist
1100 S PONCE DE LEON BLVD STE 1
ST AUGUSTINE, FL 32084
Psychologist
1100 S PONCE DE LEON BLVD STE 1
ST AUGUSTINE, FL 32084
Psychologist
1100 S PONCE DE LEON BLVD STE 1
SAINT AUGUSTINE, FL 32084
Social Worker (Clinical)
1100 S PONCE DE LEON BLVD STE 1
SAINT AUGUSTINE, FL 32084
Social Worker (Clinical)
1100 S PONCE DE LEON BLVD STE 1
ST AUGUSTINE, FL 32084
Counselor (Mental Health)
1100 S PONCE DE LEON BLVD STE 1
SAINT AUGUSTINE, FL 32084
Counselor (Mental Health)
1100 S PONCE DE LEON BLVD STE 1
ST AUGUSTINE, FL 32084
Counselor (Mental Health)
1100 S PONCE DE LEON BLVD STE 1
SAINT AUGUSTINE, FL 32084

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 Mary Kerllenevich's NPI number?

The NPI number for Mary Kerllenevich is 1386713048. It was assigned to this individual provider in the NPPES registry on November 7, 2006.

Where is Mary Kerllenevich located?

Mary Kerllenevich practices at 1100 S Ponce De Leon Blvd Ste 1, St Augustine, FL 32084. The listed phone number is (904) 824-7733.

What is Mary Kerllenevich's specialty?

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

Is Mary Kerllenevich enrolled in Medicare?

Yes. Mary Kerllenevich is registered in the Medicare PECOS enrollment system.

What insurance does Mary Kerllenevich accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Florida Health Care Plans, Oscar Health Maintenance Organization of Florida and Providence Health Plan and 1 other insurer list Mary Kerllenevich 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 Mary Kerllenevich was last updated on August 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.