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Active NPI 1144562695 Individual Practitioner Male Practitioner

Dr. John Travis Blaze , PhD

Psychologist • Gulf Breeze, FL

Professional Overview & Biography Verified Profile Summary

Dr. John Blaze, PhD is a registered healthcare professional specializing in Psychologist in Gulf Breeze, FL. Practice services are available at 5396 LONGHORN TRL under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5396 Longhorn Trl

Gulf Breeze, FL 325639353

Telephone 8502707773

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Gulf Breeze, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 39.0 Yrs
State Avg: 25.8 Yrs
Regional Practice Density
7 Specialists

Practicing in Gulf Breeze, FL (2327 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-08-18
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License FL PY9366

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 18, 2023

Psychologist (License #PY9366 in FL)

📍
Updated Practice Location March 14, 2022

Registered at 5396 LONGHORN TRL, GULF BREEZE, FL 325639353 (Tel: 8502707773)

📍
Updated Business Mailing Address March 14, 2022

Registered at 5396 LONGHORN TRL, GULF BREEZE, FL 325639353 (Tel: 8502707773)

NPI Profile Active March 22, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location March 22, 2013

Registered at 8000 DEVEREUX DR, VIERA, FL 329407907 (Tel: 3212429100)

📍
Updated Business Mailing Address March 22, 2013

Registered at 8000 DEVEREUX DR, VIERA, FL 329407907 (Tel: 3212429100)

👤
Provider Name / Credentials Updated March 22, 2013

Recorded as JOHN BLAZE, PH.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2013

Counselor

🟢
Initial NPI Registration & Enumeration March 22, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1144562695
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 22, 2013
Last Update: August 18, 2023
Sole Proprietor: No

Mailing Address

5396 Longhorn Trl

Gulf Breeze, FL 325639353

Phone: 8502707773

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.