AJAHLEI BROADUS (NPI# 1255835716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255835716 |
| Entity Type | Individual |
| Full Name | AJAHLEI BROADUS |
| Practice Address |
1128 Beville Rd Daytona Beach FL 32114-5747 |
| Mailing Address |
175 Middle St Unit 1201 Lake Mary FL 32746-3625 |
| Practice Telephone | 3862673161 |
| Mailing Telephone | 8666100580 |
| Mailing Fax Number | 8666100580 |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2018-03-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 009093700 | 05 |
| Street Address |
1128 BEVILLE RD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-5747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720398894 | Allison Marie Berard | Behavioral Analyst | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2010-10-07 |
| 1659918563 | Amira Valle | Behavior Technician | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2019-12-10 |
| 1205482916 | Joel Sampson | Behavior Technician | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2019-08-18 |
| 1255899001 | Stacy Rae Ashlaw | Behavior Technician | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2019-03-11 |
| 1750848222 | Katelyn Marie Deshon | Behavior Technician | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2019-02-20 |
| 1003394941 | Alexas Thomas | Behavior Technician | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2018-08-02 |
| 1942796842 | Nikia Cook | Behavior Technician | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2018-07-03 |
| 1699265991 | Richarde' Anderson | Behavior Technician | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2018-05-14 |
| 1144726688 | Kimber Leigh Schweke | Behavior Technician | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2018-04-03 |
| 1710480215 | Ames Benjamin Clark | Behavior Technician | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2018-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982160412 | The Arc of Volusia, Inc. | Behavioral Analyst | 100 Jimmy Huger Cir, Daytona Beach, FL 32117-5108 | 2019-02-20 |
| 1609397843 | Nia Ruth | Behavioral Analyst | 312 Sutton Cir Apt 84, Daytona Beach, FL 32114-7812 | 2017-06-28 |
| 1407302599 | Christine Lapila | Behavioral Analyst | 201 Thornberg Branch Lane, Daytona Beach, FL 32124 | 2016-08-29 |
| 1710360045 | Raven Johnson | Behavioral Analyst | 524 Arnold Dr, Daytona Beach, FL 32114-5775 | 2015-07-06 |
| 1760898241 | Takeisha R Myers | Behavioral Analyst | 1128 Beville Rd., Daytona Beach, FL 32114 | 2014-07-07 |
| 1649695628 | Amy L. Wagner | Behavioral Analyst | 1128 Beville Road, Suite A, Daytona Beach, FL 32114 | 2014-02-27 |
| 1235554676 | Ashli N. Ford | Behavioral Analyst | 1128 Beville Road, Suite A, Daytona Beach, FL 32114 | 2014-02-21 |
| 1760785430 | Stephanie Ann Swinton | Behavioral Analyst | 1128 Beville Rd Ste A, Daytona Beach, FL 32114-5769 | 2010-12-17 |
| 1720398894 | Allison Marie Berard | Behavioral Analyst | 1128 Beville Rd, Daytona Beach, FL 32114-5747 | 2010-10-07 |
| 1699393025 | Victoria Rose Sirianni | Behavioral Analyst | 1128 Beville Rd Ste A, Daytona Beach, FL 32114-5769 | 2020-07-13 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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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.