Organization
M TAVERAS PSYD & COMPANY PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CHRISTY TAVERAS PSYD (OWNER/CLINICAL PSYCHOLOGIST)
(347) 251-2090
Entity
Organization
Contact information
Practice address
1629 RACE TRACK RD STE 102, SAINT JOHNS, FL 32259-6299
(904) 204-2433
(904) 675-0987
Mailing address
13241 BARTRAM PARK BLVD UNIT 805, JACKSONVILLE, FL 32258-5216
(904) 373-8427
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
03/20/2025
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