Amelia Behavioral Wellness LLC
Organization Active NPI Clinical Psychologist · Fernandina Beach, FL
NPI 1053944330 · NPPES record last updated May 17, 2022
Key facts
- NPI
- 1053944330
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- AMELIA BEHAVIORAL WELLNESS LLC
- Practice address
- 1890 S 14TH St Ste 140
Fernandina Beach, FL 32034-4718 - Phone
- (205) 370-1832
- NPI assigned
- Feb 14, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Patricia Barreto, PHD
- Title
- Clinical Psychologist
- Phone
- (205) 370-1832
Practitioners 8
-
Patricia Barreto, PH.D
-
Denise Dutchak-Parmenter, M.D.
-
Tasha Ellsberry, APRN, FNP, PMHNP-BC
-
Felix Alexander Soleh, APRN, PMHNP-C
-
Ross Davin Wise, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200616000862 | FL | Part B Supplier - Clinic/Group Practice | 6800218165 |
Receives reassigned benefits from 4 practitioners Practice locations: Orange Park, FL; Fernandina Beach, FL |
National Provider Directory
Locations
1890 S 14th St
Ste 140
Fernandina Beach, FL 32034
Phone (205) 370-1832
1896 S 14th St
Ste 6
Fernandina Beach, FL 32034
Phone (904) 310-9652
1896 S 14th St
Fernandina Beach, FL 32034
Phone (904) 310-9652
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | Yes |
Addresses
Primary practice location
1890 S 14TH St Ste 140
Fernandina Beach, FL 32034-4718
Mailing address
2117 Jekyll CT
Fernandina Beach, FL 32034-4403
Phone (205) 370-1832
Other providers in Fernandina Beach, FL
- Melvita J Allen
- Alliance Internal Medicine, PLLC
- Matthew Harold Altman
- Amelia Anesthesia, PL
- Amelia Audiology
- Amelia Chiropractic Clinic
- Amelia Dental Group, PLLC
- Amelia Express Care, LLC
- Amelia Express Care, LLC
- Amelia Eye Associates LLC
All providers in Fernandina Beach, FL · Clinical Psychologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.