Psi Behavioral Health, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PSI BEHAVIORAL HEALTH, LLC

Practice address

3450 Dunn Ave Ste 201
Jacksonville, FL 32218-6427

Phone

(904) 723-6049

NPI assigned

Jul 17, 2013

Organization subpart

No

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

Authorized official

Name

Ricky WallaceNPI 1538455142

Title

Ceo

Phone

(904) 534-4937

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Psi Behavioral Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Psi Behavioral Health LLC

  • Case Management Agency
  • Jacksonville, FL
  • NPI 1063847465
  NPD tax ID

Locations

Practitioners 4

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

• Ricky Wallace

  • Social Worker
  • Jacksonville, FL
  • NPI 1538455142
  NPD Authorized official
• Donita Jones, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
  • NPI 1326577545
  NPD
• Kimberly Hill

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1114846441
  NPD (past)
• Norma E Owens-Hixon, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1730663113
  NPD (past)

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1154762284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 DUNN AVE STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186427",
            "telephone_number": "904-723-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 DUNN AVE STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186427",
            "telephone_number": "904-723-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSI BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-534-4937"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009163800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karin Prussak, DNP
• Christopher Pryce II
• Taliya A Pryor, BS
• Joseph John Przybylowicz, CRNA
• Psi Behavioral Health LLC
• Psychaccess and Recovery Solutions, LLC
• Psychiatric Solutions LLC
• Psychiatry by Mantilla-Rivas
• Psychoeducational Consultant Group
• PT Works LLC

• Community/Behavioral Health Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.