Alicia Elisa Ayala Laconich, PH.D IN PSYCHOLOGY

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY10781 Issued in FL

Practice address

12574 Flagler Center Blvd
Ste 101
Jacksonville, FL 32258-2615

Phone

(904) 374-4276

Fax

(888) 495-1508

NPI assigned

Mar 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baptist Behavioral Health LLCGroup PAC ID 7315166394, 120 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.95 of 100Reported as group

Quality

84.69

Promoting interoperability

100

Improvement activities

40

Cost

74.91

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alaconich123266@baptisthealthsystemjacksonville.direct-ci.com

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.

• Baptist Behavioral Health, LLC

  • Professional Counselor
  • Jacksonville, FL
  • NPI 1215906649
  Medicare reassignment Care Compare group NPD
• Dr. Elisa Laconich, PH.D., PLLC

  • Clinical Neuropsychologist
  • Jacksonville, FL
  • NPI 1598341307
  NPD Authorized official
• Southern Baptist Hospital of Florida Inc

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1841351632
  NPD (past)

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1376138495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12574 FLAGLER CENTER BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12574 FLAGLER CENTER BLVD",
            "address_2": "STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582615",
            "telephone_number": "904-374-4276",
            "fax_number": "888-495-1508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Palm Ave Ste 4A017",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078432",
            "country_code": "US",
            "telephone_number": "904-376-3800",
            "fax_number": "904-390-7395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYALA LACONICH",
        "first_name": "ALICIA",
        "middle_name": "ELISA",
        "name_prefix": "Dr.",
        "credential": "PH.D IN PSYCHOLOGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY10781",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10781",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louise Ann Axelberg
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• Salwa S Ayad, M.D.
• Ayadaway Health Services LLC
• Carla Ayala Soriano, MD
• Andres Ayala, FNP-C
• Ernesto Ayala, MD
• Monica Ayala
• Charles Mosadoluwa Ayanleke, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.