Organization Active NPI

Neurobehavioral Specialists of Jacksonville Inc

  • Clinical Neuropsychologist
  • Jacksonville, FL
National Provider Identifier
1376941310
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY8710 Issued in FL
Legal business name
NEUROBEHAVIORAL SPECIALISTS OF JACKSONVILLE INC
Practice address
4110 Southpoint Blvd Ste 212
Jacksonville, FL 32216-0927
Phone
(352) 682-0060
NPI assigned
Dec 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Authorized official

Name
Michelle A Prosje, PSYD
Title
Owner
Phone
(352) 682-0060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X PY8710 FL Primary

Addresses

Primary practice location

4110 Southpoint Blvd Ste 212
Jacksonville, FL 32216-0927

Mailing address

4110 Southpoint Blvd Ste 212
Jacksonville, FL 32216-0927
Phone (352) 682-0060

Other names 1

  • NBS-JAX Doing business as

National Provider Directory

National Provider Directory

Locations

12443 San Jose Blvd
Ste 503
Jacksonville, FL 32223
Phone (904) 685-1234

4110 Southpoint Blvd
Ste 212
Jacksonville, FL 32216
Phone (352) 682-0060

NPI Registry JSON

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1376941310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 SOUTHPOINT BLVD STE 212",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160927",
            "telephone_number": "352-682-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 SOUTHPOINT BLVD STE 212",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160927",
            "telephone_number": "352-682-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROBEHAVIORAL SPECIALISTS OF JACKSONVILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "PROSJE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-682-0060",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY8710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NBS-JAX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 8, 2014; 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.