Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1386713048 Individual Practitioner Female Practitioner

Dr. Mary Alston Kerllenevich , PhD

Psychologist • St Augustine, FL

Professional Overview & Biography Verified Profile Summary

Dr. Mary Kerllenevich, PhD is a registered healthcare professional specializing in Psychologist in St Augustine, FL. Practice services are available at 1100 S PONCE DE LEON BLVD STE 1 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1100 S Ponce De Leon Blvd Ste 1

St Augustine, FL 320846013

Telephone 9048247733
Fax 9048299768
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in St Augustine, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 44.0 Yrs
State Avg: 25.8 Yrs
Regional Practice Density
10 Specialists

Practicing in St Augustine, 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

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License FL PY7744

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.

Psychologist - Clinical

NUCC Taxonomy Code: 103TC0700X

State License FL PY7744

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Practice Associates & Co-Workers

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

18 Associated Practitioners
NPI 1003999608
Alyssa Thaxton , LCSW

Social Worker - Clinical

NPI 1043544356

Licensed Clinical Social Worker

NPI 1063502383
Stephen Henneka , LCSW

Social Worker - Clinical

NPI 1104916428

Licensed Clinical Social Worker

Yuliya Caprietta , ARNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1124555628

Advanced Registered Nurse Practitioner

Patricia Lewis-Slayton , LCSW, LMFT

Counselor - Mental Health

NPI 1215010822

Licensed Clinical Social Worker, 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 August 12, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location August 12, 2008

Registered at 1100 S PONCE DE LEON BLVD STE 1, ST AUGUSTINE, FL 320846013 (Tel: 9048247733)

📍
Updated Business Mailing Address August 12, 2008

Registered at 1100 S PONCE DE LEON BLVD STE 1, ST AUGUSTINE, FL 320846013 (Tel: 9048247733)

👤
Provider Name / Credentials Updated August 12, 2008

Recorded as MARY KERLLENEVICH, PH.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 12, 2008

Psychologist (License #PY7744 in FL)

🟢
Initial NPI Registration & Enumeration November 07, 2006

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: 1386713048
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 07, 2006
Last Update: August 12, 2008
Sole Proprietor: Yes

Mailing Address

1100 S Ponce De Leon Blvd Ste 1

St Augustine, FL 320846013

Phone: 9048247733

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.