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Individual

DR. MICHAEL JOHN HERKOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
11512 LAKE MEAD AVE, SUITE 301, JACKSONVILLE, FL 32256
(904) 645-0114
(904) 645-0115
Mailing address
11512 LAKE MEAD AVE, SUITE 301, JACKSONVILLE, FL 32256
(904) 645-0114
(904) 645-0115

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PY4681
FL
103T00000X
Psychologist
PY4681
FL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PY4681
FL
103TA0700X
Adult Development & Aging Psychologist
PY4681
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY4681
FL
103TC0700X
Clinical Psychologist
PY4681
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY4681
FL
103TF0000X
Family Psychologist
PY4681
FL
103TF0200X
Forensic Psychologist
PY4681
FL
103TP2701X
Group Psychotherapy Psychologist
Primary
PY4681
FL

Other

Enumeration date
05/22/2007
Last updated
09/11/2025
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