Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124175815 Individual Practitioner Male Practitioner

Dr. Minor Chamblin , PhD

Psychologist • Orange Park, FL

Professional Overview & Biography Verified Profile Summary

Dr. Minor Chamblin, PhD is a registered healthcare professional specializing in Psychologist in Orange Park, FL. Practice services are available at 1543 KINGSLEY AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1543 Kingsley Ave
Suite 18a

Orange Park, FL 320734535

Telephone 9042693324
Fax 9042642302
Associated Practice Facility / Clinic
🏢 Krop & Neidigh Facility NPI 1295700029

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Orange Park, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.0 Yrs
State Avg: 25.8 Yrs
Regional Practice Density
6 Specialists

Practicing in Orange Park, 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: 2019-12-17
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License FL PY 3646

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Bcbs
73837 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Joni Neidigh , LMHC

Counselor - Mental Health

NPI 1093864555

Licensed Mental Health Counselor

Caitlin Laurence

Counselor - Mental Health

NPI 1154097707
Theresa Crockett , LMHC

Counselor - Mental Health

NPI 1164571683

Licensed Mental Health Counselor

William Hughes , LMHC

Counselor - Mental Health

NPI 1407903107

Licensed Mental Health Counselor

Cheryl Carlyon , LMHC

Counselor - Mental Health

NPI 1437206281

Licensed Mental Health Counselor

Carole Nelson , LMFT

Marriage & Family Therapist

NPI 1447307137

Licensed Marriage and Family Therapist

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active September 25, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location September 25, 2012

Registered at 1543 KINGSLEY AVE, SUITE 18A, ORANGE PARK, FL 320734535 (Tel: 9042693324)

📍
Updated Business Mailing Address September 25, 2012

Registered at 1543 KINGSLEY AVE, ORANGE PARK, FL 320734535 (Tel: 9042693324)

👤
Provider Name / Credentials Updated September 25, 2012

Recorded as MINOR CHAMBLIN, PH.D

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 25, 2012

Psychologist (License #PY 3646 in FL)

🟢
Initial NPI Registration & Enumeration January 04, 2007

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: 1124175815
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 04, 2007
Last Update: December 17, 2019
Sole Proprietor: No

Mailing Address

1543 Kingsley Ave

Orange Park, FL 320734535

Phone: 9042693324

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.