NPIMap

Organization Active NPI

William L Ross

Doing business as Amelia Psychological Services

  • Marriage & Family Therapist
  • Fernandina Beach, FL
National Provider Identifier
1083834246
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
PY2557 Issued in FL
Legal business name
WILLIAM L ROSS
Doing business as
Amelia Psychological Services
Practice address
1405 Park Ave
Suite 202
Fernandina Beach, FL 32034-1950
Phone
(904) 277-2052
Fax
(904) 277-2083
NPI assigned
Apr 27, 2007
Last updated
Jun 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Authorized official

Name
William L Ross, PH.D.
Title
Business Owner
Phone
(904) 277-2052

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH6579 FL
Psychologist 103T00000X PY4456 FL
Psychologist 103T00000X PY2557 FL
Clinical Social Worker 1041C0700X SW6913 FL
Marriage & Family Therapist 106H00000X PY2557 FL Primary

Addresses

Primary practice location

1405 Park Ave
Suite 202
Fernandina Beach, FL 32034-1950

Mailing address

1405 Park Ave
Suite 202
Fernandina Beach, FL 32034-1950
Phone (904) 277-2052

Other names 1

  • Amelia Psychological Services Doing business as

National Provider Directory

National Provider Directory

Locations

1405 Park Ave
Ste 202
Fernandina Beach, FL 32034
Phone (904) 277-2052

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1083834246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 PARK AVE",
            "address_2": "SUITE 202",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341950",
            "telephone_number": "904-277-2052",
            "fax_number": "904-277-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 PARK AVE",
            "address_2": "SUITE 202",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341950",
            "telephone_number": "904-277-2052",
            "fax_number": "904-277-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM L ROSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "904-277-2052",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6579",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY4456",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY2557",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6913",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "PY2557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amelia Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.