M Taveras PSYD & Company Psychological Services

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

M TAVERAS PSYD & COMPANY PSYCHOLOGICAL SERVICES

Practice address

1629 Race Track Rd Ste 102
Saint Johns, FL 32259-6299

Phone

(904) 204-2433

Fax

(904) 675-0987

NPI assigned

Mar 18, 2024

Organization subpart

No

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

Authorized official

Name

Michelle Christy Taveras, PSYDNPI 1972886323

Title

Owner/Clinical Psychologist

Phone

(347) 251-2090

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Christy Taveras, MSW, PSY.D.

  • Clinical Psychologist
  • Saint Johns, FL
  • NPI 1972886323
  Medicare reassignment Care Compare group NPD Authorized official
• Vicki Glabb, MA, NCC, LPC

  • Counselor
  • St Petersburg, FL
  • NPI 1548576150
  Medicare reassignment Care Compare group NPD
• Lisa Ann Mason, LMHC

  • Mental Health Counselor
  • St Augustine, FL
  • NPI 1811689292
  NPD
• Jessica Pitts, LMHC

  • Mental Health Counselor
  • Saint Johns, FL
  • NPI 1306690409
  NPD

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1093574592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 805",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585216",
            "telephone_number": "904-373-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 RACE TRACK RD STE 102",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322596299",
            "telephone_number": "904-204-2433",
            "fax_number": "904-675-0987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M TAVERAS PSYD & COMPANY PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "TAVERAS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "CHRISTY",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "347-251-2090",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Lowden, PT, DPT
• Charles Lund, DPT
• Katie Marie Lutgens
• Edward Douglas Lyle II, DPT/MOT
• Leslie Anne Lynn, DC
• Kelsie Mack, PHARMD
• Alexis Maureen Macneill
• Amanda Ann Cook Mafinejad
• Skylyr Rose Magliochetti
• Mahdi A Mahdi, IDC

• Adult Mental Health Clinic/Center in Saint Johns, FL
• Providers in Saint Johns, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.