Maureen Teresa Dougherty, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY12492 Issued in FL

Practice address

1650 Prudential Dr Ste 210
Jacksonville, FL 32207-8149

Phone

(904) 376-3800

NPI assigned

Apr 10, 2013

Last updated

Aug 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, AL, FL3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Baptist Behavioral Health, LLC

  • Professional Counselor
  • Jacksonville, FL
  • NPI 1215906649
  Medicare reassignment NPD
• Health Services Inc

  dba Hayneville Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Hayneville, AL
  • NPI 1598788218
  Medicare reassignment NPD
• Pike Road Counseling, LLC

  • Community/Behavioral Health Agency
  • Pike Road, AL
  • NPI 1437681814
  Medicare reassignment NPD
• All Generations Counseling, Coaching and Consulting

  • Community/Behavioral Health Agency
  • Elgin, IL
  • NPI 1093117814
  NPD (past) Authorized official
• All Generations Counseling, Coaching and Consulting

  • Voluntary or Charitable Agency
  • Elgin, IL
  • NPI 1972929933
  NPD (past) Authorized official
• Health Services Inc

  dba River Region Health Center

  • Federally Qualified Health Center (FQHC)
  • Montgomery, AL
  • NPI 1205844719
  NPD
• Health Services, Inc.

  dba Living Well Specialty Clinic

  • Federally Qualified Health Center (FQHC)
  • Montgomery, AL
  • NPI 1184284986
  NPD

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1811330608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 PRUDENTIAL DR STE 210",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078149",
            "telephone_number": "904-376-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MAUREEN",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.00857",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY12492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Gautier Doty, MD
• Karina Mireille Doucet, MD
• Odessa Doucet, MSN, APRN, FNP-C
• Kathryn Dougan
• Marjorie Dougherty, MS
• Kathryn Doughty
• Douglas M Castellano MD PA
• Abigail Douglas
• Adam C Douglas
• Bethany Ann Douglas, D.M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.