MRS. SAMANTHA KONIECZKI (NPI# 1275099905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275099905 |
| Entity Type | Individual |
| Full Name | MRS. SAMANTHA KONIECZKI |
| Credential | RBT |
| Practice Address |
5302 S Florida Ave Lakeland FL 33813-4922 |
| Practice Telephone | 8639378067 |
| Mailing Telephone | 8639378067 |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 020984400 | 05 |
| Street Address |
5302 S FLORIDA AVE |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-4922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356347702 | Christopher Vernon Davenport | Psychiatry & Neurology | 5302 S Florida Ave, Ste 206, Lakeland, FL 33813-4910 | 2005-06-21 |
| 1164874673 | Ashley Murray | Behavioral Analyst | 5302 S Florida Ave, Suite 202, Lakeland, FL 33813-4922 | 2016-07-08 |
| 1265883391 | Sarah Elizabeth Hester | Behavioral Analyst | 5302 S Florida Ave, Suite 202, Lakeland, FL 33813-4922 | 2016-06-30 |
| 1023493335 | Carrie A Shriner | Behavioral Analyst | 5302 S Florida Ave, Suite 202, Lakeland, FL 33813-4922 | 2015-07-28 |
| 1437442977 | Brooklynn Simmons | Behavioral Analyst | 5302 S Florida Ave, Suite 206, Lakeland, FL 33813-4922 | 2011-05-17 |
| 1437441375 | Amy Morris | Behavioral Analyst | 5302 S Florida Ave, Suite 206, Lakeland, FL 33813-4922 | 2011-05-11 |
| 1295067593 | Holladay Child Development Services,llc | Behavioral Analyst | 5302 S Florida Ave, Suite 202, Lakeland, FL 33813-4922 | 2010-02-11 |
| 1598097040 | Andrea L Holladay | Behavioral Analyst | 5302 S Florida Ave, Suite 206, Lakeland, FL 33813-4922 | 2010-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| 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 |
|---|---|---|---|---|
| 1851990154 | Caitlin Shultz | Behavior Technician | 1604 Unitah Ave, Lakeland, FL 33803-1946 | 2020-10-19 |
| 1881202034 | Yenisleidy Alonso Herrera | Behavior Technician | 4040 Marie Dr, Lakeland, FL 33813-3932 | 2020-07-14 |
| 1356965297 | Deyshawnta Gardner | Behavior Technician | 2920 Morgan Combee Rd, Lakeland, FL 33801-2940 | 2020-06-06 |
| 1720549116 | Joy Marie Dresser | Behavior Technician | 1284 Devin Oaks Ct Fl 33811, Lakeland, FL 33811-2383 | 2019-03-27 |
| 1124584305 | Katherine Harris | Behavior Technician | 600 Lake Hollingsworth Dr, Lakeland, FL 33803-2364 | 2019-02-13 |
| 1366913436 | Tatiana Cordova | Behavior Technician | 3151 Hardin Combee Rd Fl 33801, Lakeland, FL 33801-3019 | 2018-12-16 |
| 1891261970 | Juneelym Figueroa | Behavior Technician | 921 E Parker St Ste 1, Lakeland, FL 33801-1901 | 2018-10-16 |
| 1396242020 | Mabel V Aportela | Behavior Technician | 2346 Sebago Dr, Lakeland, FL 33805-8005 | 2018-04-09 |
| 1154828887 | Elena Antonia Garces Quintana | Behavior Technician | 10950 Sportsman Trl, Lakeland, FL 33809-1160 | 2018-04-09 |
| 1124527163 | Ashley Lois Jenkins | Behavior Technician | 4922 Wildflower Dr, Lakeland, FL 33811-1565 | 2018-02-05 |
| Find all providers in LAKELAND | ||||
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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.