Positive Change Mental Health LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY8463 Issued in FL

Legal business name

POSITIVE CHANGE MENTAL HEALTH LLC

Practice address

6620 Southpoint Dr S Ste 450F
Jacksonville, FL 32216-0912

Phone

(904) 383-7352

NPI assigned

Oct 26, 2012

Last updated

Jan 8, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Paul Daniel Knabb, PHDNPI 1528317203

Title

Owner

Phone

(904) 383-7352

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Daniel Knabb, PH.D.

  • Counseling Psychologist
  • Jacksonville, FL
  • NPI 1528317203
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1033462163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9771 RIDDLE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322201919",
            "telephone_number": "904-383-7352",
            "fax_number": "904-404-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 SOUTHPOINT DR S STE 450F",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160912",
            "telephone_number": "904-383-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE CHANGE MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-26",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "KNABB",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-383-7352",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY8463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.