Organization Active NPI

Justin a Darienzo PSYD Abpp PA

  • Clinical Psychologist
  • Jacksonville, FL
National Provider Identifier
1417193418
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7397 Issued in FL
Legal business name
JUSTIN A DARIENZO PSYD ABPP PA
Doing business as
Psychological Fitness Solutions
Practice address
4651 Salisbury Rd
Suite 532
Jacksonville, FL 32256-6107
Phone
(904) 536-5312
NPI assigned
Dec 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Authorized official

Name
Dr. Justin Anthony D'Arienzo, PSY.D., ABPP
Title
Founder and Ceo
Phone
(904) 536-5312

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X PY7397 FL
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PY7397 FL Primary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X PY7397 FL

Addresses

Primary practice location

4651 Salisbury Rd
Suite 532
Jacksonville, FL 32256-6107

Mailing address

11197 Turnbridge Dr
Jacksonville, FL 32256-2337
Phone (904) 536-5312

Other names 1

  • Psychological Fitness Solutions Doing business as

National Provider Directory

National Provider Directory

Locations

4651 Salisbury Rd
Ste 532
Jacksonville, FL 32256
Phone (904) 253-7855

NPI Registry JSON

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

{
    "created_epoch": "1229817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1417193418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11197 TURNBRIDGE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562337",
            "telephone_number": "904-536-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 SALISBURY RD",
            "address_2": "SUITE 532",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566107",
            "telephone_number": "904-536-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN A DARIENZO PSYD ABPP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-21",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "D'ARIENZO",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "FOUNDER AND CEO",
        "authorized_official_telephone_number": "904-536-5312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., ABPP"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "PY7397",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7397",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY7397",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychological Fitness Solutions",
            "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 Jan 30, 2009; 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.