Individual provider Active NPI

Brian Emery, M.S., PH.D.

  • Mental Health Counselor
  • Orange Park, FL
National Provider Identifier
1649643099
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH14212 Issued in FL
Practice address
165 Wells Rd Ste 304
Orange Park, FL 32073-3037
Phone
(904) 720-4040
Fax
(904) 720-4596
NPI assigned
Nov 6, 2015
Last updated
Jan 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH14212 FL Primary

Addresses

Primary practice location

165 Wells Rd Ste 304
Orange Park, FL 32073-3037

Mailing address

165 Wells Rd Ste 304
Orange Park, FL 32073-3037
Phone (904) 720-4040

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240110000935 FL Practitioner - Mental Health Counselor 1153772504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emery Milne Psychological Group, LLCGroup PAC ID 1355695669, 10 clinicians

Practice addresses (Care Compare)

165 Wells Rd
Suite 304
Orange Park, FL 32073-3037
Phone (904) 720-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH14212FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Emery Milne Psychological Group, LLC CurrentSince Jan 1, 2024 Accepting new patients
Psychological Services of Jacksonville LLC PastSince Feb 20, 2016 Accepting new patients

Locations

165 Wells Rd
Ste 304
Orange Park, FL 32073
Phone (904) 720-4040

1734 Kingsley Ave
Ste 2
Orange Park, FL 32073
Phone (904) 720-4040

2220 County Road 210 W
Ste 108
St Johns, FL 32259
Phone (787) 432-0893

213 Reeceville Rd
Ste 32
West Brandywine, PA 19320
Phone (610) 384-1600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1649643099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 WELLS RD STE 304",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733037",
            "telephone_number": "904-720-4040",
            "fax_number": "904-720-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 WELLS RD STE 304",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733037",
            "telephone_number": "904-720-4040",
            "fax_number": "904-720-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERY",
        "first_name": "BRIAN",
        "credential": "M.S., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-06",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.