Eaw Psychology LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

EAW PSYCHOLOGY LLC

Practice address

14286 Beach Blvd Ste 19177
Jacksonville, FL 32250-1561

Phone

(904) 497-2423

NPI assigned

Feb 21, 2024

Organization subpart

No

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

Authorized official

Name

Ellen Williams, PHD

Title

President

Phone

(904) 497-2423

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1528823200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14286 BEACH BLVD STE 19177",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14286 BEACH BLVD STE 19177",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501561",
            "telephone_number": "904-497-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAW PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-497-2423",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.