MRS. JULIE ANNA MALL (PSY.21501D) – Clinical Psychologist, NPI 1114191426

MRS. JULIE ANNA MALL (PSY.21501D) is a healthcare provider. based in Satellite beach, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.21501D. They hold a License No. PY6653 (FL). The NPI Number for MRS. JULIE ANNA MALL (PSY.21501D) is 1114191426

Main info

Female
Sole Proprietor
25 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JULIE ANNA MALL (PSY.21501D)
NPI
1114191426
Phone
(321) 773-1111
Address
1127 S PATRICK DR STE 24
Enumeration Date
17 April 2008
Last Update Date
26 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7862690333
Graduation Year
2001 (25 years ago)
PAC ID
7517853369
Group Practice PAC ID
4486182342
Professional Enrollment ID
I20160224000997
Address ID
FL331314330MI201XXBLVD401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

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Provider Addresses for MRS. JULIE ANNA MALL (PSY.21501D)

  • South Patrick Drive, Satellite Beach, Brevard County, Florida, 32937, United States

    SATELLITE BEACH, FL 329373962

    Phone: (321) 773-1111

    Fax: (321) 773-1692

    Type: Location

  • 432 TORTOISE VIEW CIR

    SATELLITE BEACH, FL 329373801

    Phone:

    Type: Mailing

  • 432 TORTOISE VIEW CIRCLE

    SATELLITE BEACH, FL 329373801

    Phone: (321) 432-2865

    Fax: (321) 777-5806

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-02-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160224000997IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32937)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486182342View full group profile
NameSpecialtyState
Clinical PsychologistCA
Clinical PsychologistMD
Clinical Social WorkerMD
Clinical PsychologistCO
Mental Health CounselorMD
Clinical PsychologistNY
Clinical PsychologistTN
Clinical PsychologistNC
Clinical PsychologistTX
Clinical Social WorkerMD

Reviews

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Frequently asked questions

What federal number belongs to MRS. JULIE ANNA MALL (PSY.21501D)?
The federal identifier for MRS. JULIE ANNA MALL (PSY.21501D) is NPI 1114191426.
Is MRS. JULIE ANNA MALL (PSY.21501D) active in the national directory?
MRS. JULIE ANNA MALL (PSY.21501D)'s public NPI profile is in an active state.
What does MRS. JULIE ANNA MALL (PSY.21501D) treat or focus on?
Patients typically see MRS. JULIE ANNA MALL (PSY.21501D) under the specialty Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where is MRS. JULIE ANNA MALL (PSY.21501D)'s primary listing?
We display Satellite Beach, Florida because that is what the record indicates for MRS. JULIE ANNA MALL (PSY.21501D).
How can I contact MRS. JULIE ANNA MALL (PSY.21501D)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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