PROVERBS 22:6 BEHAVIORAL THERAPY INC (NPI# 1649886664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649886664 |
| Entity Type | Organization |
| Organization Name | PROVERBS 22:6 BEHAVIORAL THERAPY INC |
| Practice Address |
1086 Sw Colorado Ave Port St Lucie FL 34953-1803 |
| Mailing Address |
6365 Collins Ave Apt 4406 Miami Beach FL 33141-9622 |
| Practice Telephone | 3054390263 |
| Practice Fax Number | 7862883617 |
| Mailing Telephone | 3054390263 |
| Mailing Fax Number | 7862883617 |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-16 |
| Authorized Official Name | ROBERT JAMES KIDD (PRESIDENT) |
| Authorized Official Telephone | 3054390263 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 002500900 | 05 |
| Street Address |
1086 SW COLORADO AVE |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34953-1803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578757217 | Karin Ramtahol | Licensed Practical Nurse | 1086 Sw Colorado Ave, Port St Lucie, FL 34953-1803 | 2007-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733720 | Paul Desantis | Optometrist | 1805 Gatlin Blvd, Port St. Lucie, FL 34953 | 2020-05-29 |
| 1174165997 | D&r Homehealthcare LLC | Technician | 1210 Southwest Santiago Avenue, Port Saint Lucie, Fl, FL 34953 | 2019-10-14 |
| 1023677630 | Physical Therapy Wellness Group | Clinic/Center | 519 Sw Nagle Place, Port Saint Lucie, FL 34953 | 2019-06-07 |
| 1063993699 | Bloom Firm, LLC | Home Health | 1714 Sw Cycle St, Port Saint Lucie, FL 34953 | 2018-08-22 |
| 1386121333 | For His Glory Alf LLC. | Assisted Living Facility | 322 Sw South Quick Circle, Port St Lucie, FL 34953 | 2018-07-23 |
| 1730670555 | Susan May Thyme | Nurse Practitioner | 1762 Sw Choate St, Port Saint Lucie, FL 34953 | 2018-05-29 |
| 1164911301 | Viven Banks | Counselor | 3581 Sw Kromrey St, Port Saint Lucie, FL 34953 | 2018-05-03 |
| 1205323441 | Katherine Monroig | Behavior Technician | 4557 Se Babylon St, Port Saint Lucie, FL 34953 | 2018-04-13 |
| 1528567583 | Roger Rene Trudel | Nurse Practitioner | 3686 Sw Carmody Street, Port St Lucie, FL 34953 | 2018-02-06 |
| 1801315502 | Metushela Nicolas | Adult Companion | 1112 Jennifer Ter, Port Saint Lucie, FL 34953 | 2017-09-13 |
| Find all providers in zip 34953 | ||||
| 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 |
|---|---|---|---|---|
| 1902439995 | Eric Gormley LLC | Behavioral Analyst | 378 Ne Surfside Ave, Port St Lucie, FL 34983-1244 | 2020-02-18 |
| 1528523883 | Richard Shoy | Behavioral Analyst | 180 Sw Paar Dr, Port St Lucie, FL 34953-3509 | 2019-01-31 |
| 1013405653 | Nicole Victoria Kenyon | Behavioral Analyst | 602 Se Starflower Ave, Port St Lucie, FL 34983-4635 | 2018-04-30 |
| 1184008740 | Aaron Mohammed | Behavioral Analyst | 191 Sw Palm Dr Apt 306, Port St Lucie, FL 34986-1901 | 2015-07-14 |
| 1689090821 | Colleen Walizer | Behavioral Analyst | 10850 S Federal Hwy # 1, Port St Lucie, FL 34952-6407 | 2014-03-12 |
| 1831511252 | Karen Shipper | Behavioral Analyst | 10850 S Federal Hwy, Suite 2, Port St Lucie, FL 34952-6407 | 2014-01-21 |
| 1548558380 | Dawn M Petrie | Behavioral Analyst | 417 Ne Armory Cir, Port St Lucie, FL 34983-1738 | 2011-07-14 |
| 1528399094 | Cindy R Davis | Behavioral Analyst | 365 Se Whitmore Dr, Port St Lucie, FL 34984-4531 | 2010-01-23 |
| 1922596485 | Jessica Emilssen Cruz Nino | Behavioral Analyst | 10850 S Us Highway 1 Ste 2, Port St Lucie, FL 34952-6407 | 2018-04-30 |
| 1356840888 | Pamela Sue Hamm | Behavioral Analyst | 10850 S Us Highway 1 Ste 2, Port St Lucie, FL 34952-6407 | 2018-02-10 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34953 |
Please comment or provide details below to improve the information on PROVERBS 22:6 BEHAVIORAL THERAPY INC.
| 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.