OLIVIA CLARK (NPI# 1164911939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164911939 |
| Entity Type | Individual |
| Full Name | OLIVIA CLARK |
| Practice Address |
2301 Crownpoint Executive Dr Ste E Charlotte NC 28227-6725 |
| Practice Telephone | 7047088314 |
| Mailing Telephone | 7047088314 |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-05-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-17-29481 | NC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226419 | Olivia Clark | Occupational Therapy Assistant | 2905 Bearcreek Ct, Fullerton, CA 92835-3143 | 2020-08-18 |
| 1366043606 | Olivia Skibba Clark | Case Manager/Care Coordinator | 5455 Almira Dr Ne, Bremerton, WA 98311-8330 | 2020-11-03 |
| 1427549864 | Olivia Clark | Behavior Technician | 527 N Meridian Rd, Youngstown, OH 44509 | 2018-05-22 |
| 1245750322 | Olivia Clark | Social Worker | 239 Golden Hill Lane, Suite 100, Kingston, NY 12401 | 2017-06-21 |
| 1740648534 | Olivia Clark | Dietitian, Registered | 3909 New Vision Dr, Fort Wayne, IN 46845-1725 | 2016-02-08 |
| 1609974393 | Olivia A Clark | Speech-Language Pathologist | 7011 Southwest Freeway, Houston, TX 77074 | 2006-09-20 |
| Street Address |
2301 CROWNPOINT EXECUTIVE DR STE E |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28227-6725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700219201 | Brittany Wray Bishop Drake | Behavioral Analyst | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227 | 2013-08-20 |
| 1689217168 | Michelle Gant | Behavior Technician | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227-6725 | 2019-10-28 |
| 1639712102 | Alicia Dobner | Behavior Technician | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227-6725 | 2019-10-28 |
| 1396388864 | Taylor Rose | Behavior Technician | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227-6725 | 2019-10-28 |
| 1619510187 | Arianne Colabella | Behavior Technician | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227-6725 | 2019-10-28 |
| 1821631300 | Ryan Miller | Behavior Technician | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227-6725 | 2019-10-28 |
| 1619510195 | Kameron Rickard | Behavior Technician | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227-6725 | 2019-10-28 |
| 1902453780 | Kiara Bullock | Behavior Technician | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227-6725 | 2019-08-26 |
| 1245897156 | Taryn Dolan | Behavioral Analyst | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227-6725 | 2019-05-26 |
| 1821550385 | Orelle Gamble | Behavior Technician | 2301 Crownpoint Executive Dr Ste E, Charlotte, NC 28227-6725 | 2019-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396396693 | Phyllis Newsome Wilson | Technician | 8423 Empress Ct, Charlotte, NC 28227 | 2019-09-27 |
| 1134611239 | Alyssa Latonia Rodgers | Counselor | 7512 Spring Spruce Ln, Charlotte, NC 28227 | 2018-06-04 |
| 1114463429 | Andrea Henneberry | Physical Therapy Assistant | 9706 Stoney Glen Dr Apt L, Mint Hill, NC 28227 | 2017-01-10 |
| 1649726589 | Keba Bosley | Social Worker | 5912 Brightstar Valley Road, Mint Hill, NC 28227 | 2016-08-31 |
| 1710330071 | Carolina Family Services | Community/Behavioral Health | 5737 Old Magnolia Lane, Mint Hill, NC 28227 | 2016-07-21 |
| 1518311901 | Aynsley Girardeau | Optometrist | 7014 Tutor Street, Suite C, Mint Hill, NC 28227 | 2016-04-21 |
| 1487037875 | Shalini Kamodia | Dentist | 11300 Cresthill Dr Ste 105, Mint Hill, NC 28227 | 2015-07-02 |
| 1629455720 | Yes We Care Human Services of Mecklenburg County | Adult Companion | 8201 Willowlake Ct, Charlotte, NC 28227 | 2015-04-28 |
| 1841677077 | Hewitt Home Care | Psychiatric Residential Treatment Facility | 2331 Crownpoint Executive Drive, Charlotte, NC 28227 | 2015-04-27 |
| 1467847426 | Marguerita Sitrin Blaker | Psychologist | 2400 Crownpoint Executive Drive, Suite 100, Office #5, Charlotte, NC 28227 | 2015-04-06 |
| Find all providers in zip 28227 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619577244 | Jennifer Brickman | Behavior Technician | 905 Kenilworth Ave Apt 226, Charlotte, NC 28204-2947 | 2020-11-01 |
| 1578162475 | Jaquetta Mcpherson | Behavior Technician | 650 E Stonewall St Apt 435, Charlotte, NC 28202-3416 | 2020-10-21 |
| 1922614270 | Kalessa Grigsby | Behavior Technician | 3510 Frew Rd Apt H, Charlotte, NC 28206-4990 | 2020-09-22 |
| 1851907125 | Kayla Tyson-cardona | Behavior Technician | 13420 Cedar Farm Rd Apt 302, Charlotte, NC 28278-7543 | 2020-09-21 |
| 1558971333 | Danielle C Tain | Behavior Technician | 3443 Twelve Oaks Pl, Charlotte, NC 28270-4432 | 2020-08-05 |
| 1558971465 | Leah Danielle Dunn | Behavior Technician | 8307 University Exec Park Dr Ste 231, Charlotte, NC 28262-1381 | 2020-08-05 |
| 1255959854 | Catherine Danielle Rivers | Behavior Technician | 6647 Kemp St, Charlotte, NC 28213-5629 | 2020-07-09 |
| 1215552237 | Evelyn A Bailey | Behavior Technician | 2301 Lawry Run Dr Apt 402, Charlotte, NC 28273-3495 | 2020-06-15 |
| 1770107971 | Robert L Mckinstry | Behavior Technician | 7046 Markway Dr, Charlotte, NC 28215-3577 | 2020-06-03 |
| 1982238655 | Aleta Fraser | Behavior Technician | 10931 Pimlico Dr, Charlotte, NC 28273-7712 | 2020-03-02 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.