Meghan Ambrose, MS, LSP

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

SS1593 Issued in FL

Practice address

303 Vista Lagoon CT Unit C-1
Ponte Vedra Beach, FL 32082-5602

Phone

(858) 717-4803

NPI assigned

Jun 29, 2021

Last updated

Mar 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mandala Family Wellness LLC

  • Occupational Therapist
  • Ponte Vedra Beach, FL
  • NPI 1063296754
  NPD (past)
• Mandala Family Wellness LLC

  • Psychologist
  • Ponte Vedra Beach, FL
  • NPI 1497262620
  NPD (past)

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1134799471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 VISTA LAGOON CT UNIT C-1",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 VISTA LAGOON CT UNIT C-1",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825602",
            "telephone_number": "858-717-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "MEGHAN",
        "credential": "MS, LSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS1593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110971200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlos Aguilar
• Kristofer Brian Aigner
• Katherine Warrell Allen, ITDS
• Victoria Allen
• Monica Alvarado, PT
• Amplified Resource Group LLC
• Elizabeth Andersen, MS, LMHC
• Clare Anderson, PHARM.D.
• Angel Kids PA (Angel Kids Pediatrics)
• Nancy A Arcuri, ARNP

• School Psychologist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• School Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.