TANISHA MACK (NPI# 1629688163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629688163 |
| Entity Type | Individual |
| Full Name | TANISHA MACK |
| Practice Address |
1563 Kingsley Ave Ste 103 Orange Park FL 32073-4503 |
| Mailing Address |
300 International Parkway Suite 200 Lake Mary FL 32746-3625 |
| Practice Telephone | 9046029740 |
| Practice Fax Number | 9046374724 |
| Mailing Telephone | 8666100580 |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2020-08-07 |
| 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 |
| Street Address |
1563 KINGSLEY AVE STE 103 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063834059 | Maegan Howell | Behavioral Analyst | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073 | 2014-01-10 |
| 1235749599 | Kassandra Bryan | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-08-03 |
| 1457969941 | Ashley Moxley | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-07-21 |
| 1659989424 | Michelle Elizabeth Steneck | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-07-17 |
| 1922625052 | Madison Elise Terhune | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-07-06 |
| 1023634185 | Olivette Gray | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-06-24 |
| 1447876800 | Rachel Erin Bookbinder | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-06-22 |
| 1407471592 | Sydney Rae Balter | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-06-15 |
| 1942825674 | Noelle Brittany Malone | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-06-09 |
| 1093338063 | Jessica Diane Borre | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| 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 |
|---|---|---|---|---|
| 1437766219 | Cassia Burgess | Behavior Technician | 350 Corporate Way Ste 400, Orange Park, FL 32073-2853 | 2020-09-25 |
| 1861015265 | Jenny G. Herrera | Behavior Technician | 1700 Wells Rd # 1516, Orange Park, FL 32073-2337 | 2020-05-20 |
| 1083243901 | Jayden Alicia Mclaughlin | Behavior Technician | 1700 Wells Rd Ste 16, Orange Park, FL 32073-2374 | 2020-04-02 |
| 1386273290 | Monica Em | Behavior Technician | 1700 Wells Rd Ste 15-16, Orange Park, FL 32073-2337 | 2020-04-02 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1124532403 | Ashley Campbell | Behavior Technician | 3750 Silver Bluff Blvd Bldg 29, Orange Park, FL 32065-4262 | 2017-11-26 |
| 1629504360 | Christine Mochowski | Behavior Technician | 301 Dora Dr, Orange Park, FL 32073-8747 | 2017-05-01 |
| 1063954824 | Lenoir Anderson | Behavior Technician | 25 Knight Boxx Rd Apt 6201, Orange Park, FL 32065-8043 | 2016-11-10 |
| 1891302394 | Jalana Aareon Prevatt | Behavior Technician | 1563 Kingsley Ave, Orange Park, FL 32073-4503 | 2020-09-29 |
| 1013521061 | Daniel Duane Mcwhite | Behavior Technician | 1563 Kingsley Ave, Orange Park, FL 32073-4503 | 2020-09-06 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
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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.