Alyssa Marie Chen, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY10076 Issued in FL

Practice address

836 Prudential Dr Ste 1006
Jacksonville, FL 32207-8337

Phone

(904) 376-3800

NPI assigned

Oct 8, 2015

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 names 1

• Alyssa Marie Garofalo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1144691742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1006",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078337",
            "telephone_number": "904-376-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 Prudential Dr Ste 410",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078197",
            "country_code": "US",
            "telephone_number": "904-376-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ALYSSA",
        "middle_name": "MARIE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "GAROFALO",
            "middle_name": "MARIE",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Chemical Dependency Counseling, Inc.
• Anita Chen, MD
• Avis S. Chen, MD
• Bai XI Chen, MD MPH
• Fang Chen, MD
• Frank K Chen, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.