NPIMap

Organization Active NPI

Southern Baptist Hospital

  • Counseling Psychologist
  • Yulee, FL
National Provider Identifier
1861693632
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
SOUTHERN BAPTIST HOSPITAL
Practice address
96098 Victorias PL
Suite 201
Yulee, FL 32097-6349
Phone
(904) 376-3800
Fax
(904) 733-9598
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Ellen Williams, PHD
Title
Director
Phone
(904) 376-3800

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X FL
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X FL Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X FL

Addresses

Primary practice location

96098 Victorias PL
Suite 201
Yulee, FL 32097-6349

Mailing address

4160 University Blvd S
Jacksonville, FL 32216-4317
Phone (904) 376-3800

Other names 1

  • Psychiatric and Psychological Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
James Campbell18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1861693632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164317",
            "telephone_number": "904-376-3800",
            "fax_number": "904-733-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96098 VICTORIAS PL",
            "address_2": "SUITE 201",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320976349",
            "telephone_number": "904-376-3800",
            "fax_number": "904-733-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BAPTIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-376-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric and Psychological Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yulee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.