DERRICK ROBERTS


Address: 11302 Forestdale Rd, Jacksonville, FL 32218
Phone: 9048878811

DERRICK ROBERTS (NPI# 1427544501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427544501
Entity Type Individual
Full Name DERRICK ROBERTS
Credential BCBA
Practice Address 11302 Forestdale Rd
Jacksonville
FL 32218
Mailing Address 11302 Forestdale Rd
Jacksonville
FL 32218-3779
Practice Telephone 9048878811
Mailing Telephone 9048878811
Enumeration Date 2018-07-02
Last Update Date 2019-06-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103K00000X Behavioral Analyst Behavioral Health & Social Service Providers
N 106S00000X Behavior Technician 18-57130 SC Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
11302 Forestdale Rd, Jacksonville, FL 32218 9048878811

Office Location

Street Address 11302 FORESTDALE RD
City JACKSONVILLE
State FL
Zip Code 32218

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Taxonomy Information

Taxonomy Code 103K00000X
Grouping Behavioral Health & Social Service Providers
Classification Behavioral Analyst

Taxonomy Definition

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]

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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
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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
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Competitor

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City JACKSONVILLE
Zip Code 32218

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Dataset Information

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.

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