Individual provider Active NPI

Melissa Stephanie Roffman, PH.D.

  • Counseling Psychologist
  • Jacksonville, FL
National Provider Identifier
1326375197
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PY8013 Issued in FL
Practice address
915 W Monroe St
Suite 200
Jacksonville, FL 32204-1177
Phone
(904) 384-2240
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X
Counseling Psychologist 103TC1900X PY8013 FL Primary

Addresses

Primary practice location

915 W Monroe St
Suite 200
Jacksonville, FL 32204-1177

Mailing address

915 W Monroe St
Suite 200
Jacksonville, FL 32204-1177
Phone (904) 384-2240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY8013FLMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Baptist Hospital of Florida Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1326375197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST",
            "address_2": "SUITE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST",
            "address_2": "SUITE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROFFMAN",
        "first_name": "MELISSA",
        "middle_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY8013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.