Jennifer Pierce Lail, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY11418 Issued in FL

Practice address

1903 Island Walk Way
Fernandina Beach, FL 32034-4797

Phone

(904) 277-0027

NPI assigned

Mar 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Aug 21, 2023 through Aug 21, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Florida Psychological Associates, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fernandina, FL
  • NPI 1922496850
  NPD
• Florida Psychological & Associated Healthcare

  • Psychologist
  • Fernandina Beach, FL
  • NPI 1326419029
  NPD (past)

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1912608704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7753 MIDDLE VALLEY DR",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221532230",
            "telephone_number": "919-259-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 ISLAND WALK WAY",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344797",
            "telephone_number": "904-277-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIL",
        "first_name": "JENNIFER",
        "middle_name": "PIERCE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Michael Kostrzewski, R, MR
• Katherine Kotopka
• Gabor Kovacs, M.D.
• Erika Jean Kristensen, MSW, LCSW
• Blaine S. Kristo, MD
• Jenna Lynn Lamont, MSW
• Arnold Landsman, DPM
• David Alan Lavin, P.T.,D.P.T.,C.S.C.S.
• George Glenn Le-Bert, D.O.
• Sarah Mindedahl Leach, RCSWI

• Clinical Psychologist in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.