MARY MOORE (NPI# 1417491036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417491036 |
| Entity Type | Individual |
| Full Name | MARY MOORE |
| Credential | QASP |
| Practice Address |
10175 Fortune Pkwy Suite 903 Jacksonville FL 32256-6746 |
| Mailing Address |
921 Charlie Smith Sr Hwy Saint Marys GA 31558-2834 |
| Practice Telephone | 9045380713 |
| Practice Fax Number | 9045380714 |
| Mailing Telephone | 9045380713 |
| Mailing Fax Number | 9045380714 |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2016-12-16 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780215467 | Mary Major Moore | Massage Therapist | 335 Ne 4th St # Dt, Bend, OR 97701-5162 | 2020-01-30 |
| 1205205804 | Mary Rose Moore | Nurse Practitioner | 1443 Richmond Road, Lyndhurst, OH 44124 | 2015-09-24 |
| 1063654192 | Mary G Moore | Counselor | 103 William Dr, Normal, IL 61761-1862 | 2009-04-06 |
| 1588812325 | Mary Moore | Occupational Therapist | 6801 Copra Ln, Louisville, KY 40219-2156 | 2008-09-05 |
| 1275796625 | Mary Moore | Advanced Practice Midwife | 4118 Winnemac Ave, Madison, WI 53711-1645 | 2008-07-07 |
| 1023288123 | Mary Elizabeth Moore | Registered Nurse | 1064 Independence Ave, Akron, OH 44310 | 2008-03-04 |
| 1861672347 | Mary Patricia Moore | Psychiatry & Neurology | 280 Broad St Ste E, Kernersville, NC 27284-2948 | 2007-11-13 |
| 1134314263 | Mary Margaret Moore | Dermatology | 7435 Highway 6 Ste B, Missouri City, TX 77459-4698 | 2007-09-11 |
| 1871799957 | Mary E Moore | Psychologist | 325 W Hospitality Lane, Suite 310, San Bernandino, CA 92408-3212 | 2007-06-25 |
| 1578629309 | Mary A Moore | Social Worker | 19206 Huebner, Ste 104, San Antonio, TX 78258-9800 | 2006-12-28 |
| Street Address |
10175 FORTUNE PKWY SUITE 903 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-6746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730100587 | Mohammad Farooque | Psychiatry & Neurology | 10175 Fortune Pkwy, Suite #1106, Jacksonville, FL 32256-6746 | 2006-07-21 |
| 1902430614 | Delana Dampier | Technician | 10175 Fortune Pkwy, Jacksonville, FL 32256-6746 | 2020-03-03 |
| 1336780907 | Sunshine Medical Specialists, LLC | Pediatrics | 10175 Fortune Pkwy, Jacksonville, FL 32256-6746 | 2019-10-03 |
| 1376079905 | Ashley Raynor | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-05-02 |
| 1952834434 | Mollie Gibson | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-04-11 |
| 1720511728 | Desiree Adams | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-04-06 |
| 1538691555 | Meghan Rhegness | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-03-29 |
| 1568906048 | Alicia Miller | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2016-12-19 |
| 1720522352 | Lavyn Taylor | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2016-12-16 |
| 1730623356 | Juana Rivera | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2016-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| 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 |
|---|---|---|---|---|
| 1457951758 | Ebs Childrens Therapy - Fl LLC | Behavioral Analyst | 5491 Dolphin Point Blvd, Jacksonville, FL 32211 | 2020-10-27 |
| 1265031066 | Johnathon Monson | Behavioral Analyst | 12025 San Jose Blvd Ste 102, Jacksonville, FL 32223-1639 | 2020-10-22 |
| 1336748391 | Emily K Reeves | Behavioral Analyst | 12025 San Jose Blvd Ste 2, Jacksonville, FL 32223-1639 | 2020-10-21 |
| 1275146912 | Keepsake Learning Behavioral Services | Behavioral Analyst | 11451 Kabroon Ct, Jacksonville, FL 32246-6920 | 2020-08-24 |
| 1356962518 | Pls Therapy Services | Behavioral Analyst | 13121 Atlantic Blvd Ste 400, Jacksonville, FL 32225-0103 | 2020-04-29 |
| 1184277766 | Jade Greene Bcba LLC | Behavioral Analyst | 5332 Gathering Oaks Ct E, Jacksonville, FL 32258-3420 | 2019-07-22 |
| 1386100667 | Nicole M Cleghorn | Behavioral Analyst | 1264 Nipigon Ave S, Jacksonville, FL 32233-2226 | 2019-02-12 |
| 1548732886 | Courtney Rollings Latham | Behavioral Analyst | 12350 Shore Acres Dr, Jacksonville, FL 32225-5670 | 2018-12-27 |
| 1023583325 | Linnzi Marks | Behavioral Analyst | 6014 Wateredge Ln, Jacksonville, FL 32211 | 2018-10-12 |
| 1013482876 | Madison Buehnemann | Behavioral Analyst | 3832 Baymeadows Rd Ste 9, Jacksonville, FL 32217-5605 | 2018-10-09 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
Please comment or provide details below to improve the information on MARY MOORE.
| 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.