Organization
PSI BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY WALLACE (CEO)
(904) 534-4937
Entity
Organization
Contact information
Practice address
3450 DUNN AVE STE 201, JACKSONVILLE, FL 32218-6427
(904) 723-6049
Mailing address
3450 DUNN AVE STE 201, JACKSONVILLE, FL 32218-6427
(904) 723-6049
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009163800
—
FL
Enumeration date
07/17/2013
Last updated
11/17/2025
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