Amelia Psychological Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

AMELIA PSYCHOLOGICAL SERVICES, LLC

Practice address

1890 S 14TH St
Suite 306
Fernandina Beach, FL 32034-4740

Phone

(904) 432-7833

Fax

(904) 432-7831

NPI assigned

Jul 31, 2013

Last updated

Jul 31, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ernest Paul Bicknell III, PSY.D.NPI 1972672293

Title

Sole MBR

Phone

(904) 432-7833

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Ernest Paul Bicknell III, PSYD

  • Clinical Psychologist
  • Fernandina Beach, FL
  • NPI 1972672293
  Authorized official Same address or phone

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1174955207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 S 14TH ST",
            "address_2": "SUITE 306",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344740",
            "telephone_number": "904-432-7833",
            "fax_number": "904-432-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 S 14TH ST",
            "address_2": "SUITE 306",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344740",
            "telephone_number": "904-432-7833",
            "fax_number": "904-432-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMELIA PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "BICKNELL",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "904-432-7833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amelia Therapy Services, Inc
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• Anchored Hope LLC

• Clinical Psychologist in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.