IndividualActive
Michael Domery, PSY.D.
NPI 1629301254 · Clinical Psychologist · Jacksonville, FL
Provider details
- NPI number
- 1629301254
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PSY.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 017941 (NY)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
2080 Child St
Jacksonville, FL 32214-5005
Phone: (518) 557-3493
Approximate (ZIP-level) locationGet directions
Mailing address
2080 Child St
Jacksonville, FL 32214-5005
Registry dates
- Enumerated
- 2009-09-15
- Last updated
- 2025-03-26
- Certified
- 2025-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.