Healthcare Provider Details

I. General information

NPI: 1275450124
Provider Name (Legal Business Name): CENTERED SELF PSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5224 NW 43RD LANE RD
OCALA FL
34482-8686
US

IV. Provider business mailing address

5224 NW 43RD LANE RD
OCALA FL
34482-8686
US

V. Phone/Fax

Practice location:
  • Phone: 269-208-0002
  • Fax:
Mailing address:
  • Phone: 269-208-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. AMY C JACKSON
Title or Position: AMBR
Credential: PHD
Phone: 269-208-0002