Organization Active NPI

Behavioral Arts & Research Clinic L

  • Clinical Psychologist
  • Jacksonville, FL
National Provider Identifier
1467547091
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7115 Issued in FL
Legal business name
BEHAVIORAL ARTS & RESEARCH CLINIC L
Practice address
11798 San Jose Blvd
Suite 2
Jacksonville, FL 32223
Phone
(904) 371-4948
Fax
(904) 371-4958
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kimberly Elaine Brown, PH.D.
Title
Co-Owner Licensed Psychologist
Phone
(904) 371-4948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PY7115 FL Primary

Addresses

Primary practice location

11798 San Jose Blvd
Suite 2
Jacksonville, FL 32223

Mailing address

11798 San Jose Blvd
Suite 2
Jacksonville, FL 32223
Phone (904) 371-4948

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467547091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11798 SAN JOSE BLVD",
            "address_2": "SUITE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-371-4948",
            "fax_number": "904-371-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11798 SAN JOSE BLVD",
            "address_2": "SUITE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-371-4948",
            "fax_number": "904-371-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL ARTS & RESEARCH CLINIC L",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "CO-OWNER LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "904-371-4948",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7115",
            "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 Aug 22, 2020; 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.