Psychiatric Services of Daytona, PLCC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PSYCHIATRIC SERVICES OF DAYTONA, PLCC

Practice address

600 N Clyde Morris Blvd
Daytona Beach, FL 32114-2322

Phone

(386) 265-5512

Fax

(386) 265-5543

NPI assigned

Apr 1, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Gary FrickNPI 1962548552

Title

Owner

Phone

(386) 767-8584

Specialties & licenses 1

Addresses

Other names 1

• Psychiatric Services of Daytona, PLCC Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Northeast Florida Psychiatric Association2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Northeast Florida Psychiatric Association, Inc

  • Psychiatry Physician
  • Port Orange, FL
  • NPI 1558798405
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary William Frick, MD

  • Psychiatry Physician
  • Port Orange, FL
  • NPI 1962548552
  Medicare reassignment Care Compare group NPD Authorized official
• Kelli Nicole Bridgman, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Deland, FL
  • NPI 1588841977
  Medicare reassignment Care Compare group NPD
• Melissa Hope Acham, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Hernando, FL
  • NPI 1659084481
  Medicare reassignment NPD

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1891373601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142322",
            "telephone_number": "386-265-5512",
            "fax_number": "386-265-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142322",
            "telephone_number": "386-265-5512",
            "fax_number": "386-265-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC SERVICES OF DAYTONA, PLCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-01",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "FRICK",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-767-8584",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Services of Daytona, PLCC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Psychiatric Services of Daytona, PLCC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Proppe, MHS, LAT, ATC
• John Hunter Protheroe, PA
• Michelle Protko, LMHC
• Julie Pruitt, FLLHAS NBS HIS A5262
• Tara Pruna, M.A., CCC-SLP
• Publix Super Markets, Inc.
• Publix Super Markets, Inc.
• Publix Super Markets, Inc.
• Aaron Puebla, MD
• Maria C Puentes, ARNP

• Psychiatry Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.