NOVA SOUTHEASTERN UNIVERSITY (NPI# 1366790552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366790552 |
| Entity Type | Organization |
| Organization Name | NOVA SOUTHEASTERN UNIVERSITY |
| Other Organization Name | NSU SEVERE BEHAVIOR DISORDERS CLINIC |
| Practice Address |
3526 S University Dr Davie FL 33328-2002 |
| Mailing Address |
Po Box 290250 Davie FL 33329-0250 |
| Practice Telephone | 9542625730 |
| Practice Fax Number | 9542623855 |
| Mailing Telephone | 9542624334 |
| Mailing Fax Number | 9542623882 |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2012-08-21 |
| Authorized Official Name | ROBERT S. OLLER (CEO/DIVISION OF CLINICAL OPERATIONS) |
| Authorized Official Telephone | 9542624399 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| NSU Severe Behavior Disorders Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326386848 | Nova Southeastern University | Internal Medicine | 3424 S University Dr, Suite 3440, Davie, FL 33328-2022 | 2013-01-17 |
| 1336477397 | Nova Southeastern University | Clinic/Center | 8501 Sw 124th Ave Ste 111, Miami, FL 33183-4631 | 2009-12-02 |
| 1275878241 | Nova Southeastern University | Dentist | 819 Ne 26th St, Wilton Manors, FL 33305-1239 | 2012-12-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | NOVA SOUTHEASTERN UNIVERSITY INC. | 3301 College Ave, Davie, Florida 33314-7721 |
| System for Award Management (SAM) Entities | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Ave, Fort Lauderdale, FL 33314-7721 |
| Colorado Business Entities | NOVA SOUTHEASTERN UNIVERSITY, INC. | Nova Southeastern University, 3301 College Ave - Licensure, Fort Lauderdale, FL 33314 |
| Iowa Business Entities | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Ave, Ft Lauderdale, FL 33314 |
| Oregon Corporations, Companies and Business Names | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Ave, Fort Lauderdale, FL 33314 |
| Vermont Business Registrations | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Avenue, Ft. Lauderdale, FL 33314 |
| Indiana Business Entities | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Avenue, Fort Lauderdale, FL 33314 |
| Street Address |
3526 S UNIVERSITY DR |
| City | DAVIE |
| State | FL |
| Zip Code | 33328-2002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912259706 | Tara May Sheehan | Behavioral Analyst | 3526 S University Dr, Davie, FL 33328-2002 | 2012-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306496708 | Venise Jacqueslouis | Behavior Technician | 8001 We 36th St, Suite 9, Davie, FL 33328 | 2019-09-17 |
| 1134780539 | 1st Nursing Care Services | Registered Nurse | 10335 Sw 50th Ct, Cooper City, FL 33328 | 2019-06-26 |
| 1023572245 | Rezan Tewolde | Pharmacist | 37772 Churchill Downs Drive, Davie, FL 33328 | 2019-01-23 |
| 1497237820 | Yasmeen Dahsheh | Behavior Technician | 8001 Sw 36th Street Suite #9, Davie, FL 33328 | 2018-09-01 |
| 1831686948 | Kristal Arias | Behavior Technician | 8001 Sw 36th Street, Suite #9, Davie, FL 33328 | 2018-04-16 |
| 1952810384 | April R Hardy | Behavior Technician | 8001 Sw 36 Street Suite 9, Davie, FL 33328 | 2017-09-28 |
| 1609391556 | Courtney M Talbert | Behavior Technician | 8001 Sw 36 St, Suite 9, Davie, FL 33328 | 2017-08-11 |
| 1639619349 | Remya Mathew | General Acute Care Hospital | 10030 Grove Ln, Cooper City, FL 33328 | 2017-02-28 |
| 1184161945 | Elizabeth Stabinski | Marriage & Family Therapist | 4900 South University Drive, Suite 200d, Davie, FL 33328 | 2017-01-31 |
| 1285097659 | Pandolfi Counseling Associates, Inc. | Social Worker | 5291 Sw 89th Ave, Cooper City, FL 33328 | 2016-04-01 |
| Find all providers in zip 33328 | ||||
| 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 |
|---|---|---|---|---|
| 1366079964 | Maybel Diaz Nieves | Behavioral Analyst | 1713 Whitehall Dr Apt 306, Davie, FL 33324-6929 | 2020-03-24 |
| 1083170427 | Giamcarlo Revelo | Behavioral Analyst | 835 Sw 120th Way, Davie, FL 33325-3820 | 2019-02-11 |
| 1831666924 | Elisa Nusiner Desideri | Behavioral Analyst | 2286 Sw 81st Ave, Davie, FL 33324-5527 | 2018-10-27 |
| 1548750219 | Jamie Suzanne Grillo | Behavioral Analyst | 3404 Davie Rd Apt 301, Davie, FL 33314-1628 | 2018-05-17 |
| 1902395122 | Angelic Steps Therapy LLC | Behavioral Analyst | 5900 Sw 24th Pl Apt 203, Davie, FL 33314-1131 | 2018-05-02 |
| 1760999551 | Pediatric Behavior Therapies, LLC | Behavioral Analyst | 10281 N Lake Vista Cir, Davie, FL 33328-1103 | 2018-01-03 |
| 1134658495 | Luz Arevalo | Behavioral Analyst | 6630 Sw 41 Pl, Davie, FL 33314 | 2017-06-08 |
| 1609302660 | Athena Harris | Behavioral Analyst | 2931 Sw 87th Ter, Unit 1903, Davie, FL 33328-6669 | 2017-05-11 |
| 1043745979 | Sahar Dahsheh | Behavioral Analyst | 3159 Juniper Ln, Davie, FL 33330-1352 | 2017-04-28 |
| 1730629106 | Michelle Sereno | Behavioral Analyst | 12721 Sw 15th Mnr, Davie, FL 33325-5818 | 2017-03-03 |
| Find all providers in DAVIE | ||||
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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.