MEDICARE: DR. JUSTIN A D'ARIENZO PSY.D., ABPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TH0100X	Health Service Psychologist	PY 7397	FL
2	103TP2701X	Group Psychotherapy Psychologist	PY 7397	FL
3	103TB0200X	Cognitive & Behavioral Psychologist	PY 7397	FL
4	103TA0400X	Addiction (Substance Use Disorder) Psychologist	PY 7397	FL
5	103TC0700X	Clinical Psychologist	PY 7397	FL
6	103TC0700X	Clinical Psychologist	PY7397	FL
7	103TF0000X	Family Psychologist	PY 7397	FL

General Provider Information

NPI Number	:	1144294174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN A D'ARIENZO PSY.D., ABPP

Provider Business Mailing Address
First Line	:	6058 SAN JOSE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2358
Country	:	US
Telephone Number	:	904-379-8094
Fax Number	:	904-379-8688

Provider Business Practice Location Address
First Line	:	6058 SAN JOSE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2358
Country	:	US
Telephone Number	:	904-379-8094
Fax Number	:	904-379-8688

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	02/12/2025

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Directions to “ DR. JUSTIN A D'ARIENZO PSY.D., ABPP” Practice Location

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