Psychological Services of St. Augustine

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PY2444 Issued in FL

Legal business name

PSYCHOLOGICAL SERVICES OF ST. AUGUSTINE

Practice address

1100 S Ponce de Leon Blvd Ste 1
St Augustine, FL 32084-6013

Phone

(904) 824-7733

NPI assigned

Jan 12, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jack Merwin, PHD.NPI 1619050473

Title

Owner

Phone

(904) 824-7733

Specialties & licenses 2

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack Melvin Merwin, PSYCHOLOGIST

  • Cognitive & Behavioral Psychologist
  • St Augustine, FL
  • NPI 1619050473
  Authorized official Same address or phone
• Odalys Brito, M.D.

  • Psychiatry Physician
  • Vero Beach, FL
  • NPI 1396765798
  NPD (past)
• Stanley A Cohen, D.O.P.A.

  • Child & Adolescent Psychiatry Physician
  • St Augustine, FL
  • NPI 1457437584
  NPD (past)
• John Mark Joyce, M. D.

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1265662696
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1952451775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100-1 SOUTH PONCE DE LEON BLVD.",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32084",
            "telephone_number": "904-824-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "904-824-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES OF ST. AUGUSTINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MERWIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-824-7733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "PY2444",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "FL",
            "license": "PY2444",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jessica Diane Proveaux
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• Mental Health Counselor in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Mental Health Counselor in Florida

• 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.