BLAINE STIGLETS (NPI# 1700492592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700492592 |
| Entity Type | Individual |
| Full Name | BLAINE STIGLETS |
| Credential | RBT |
| Practice Address |
15489 Dedeaux Rd Gulfport MS 39503-2667 |
| Mailing Address |
2417 22nd Ave Gulfport MS 39501-4624 |
| Practice Telephone | 2283575671 |
| Mailing Telephone | 2283800355 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-20-134263 | MS | Behavioral Health & Social Service Providers |
| Street Address |
15489 DEDEAUX RD |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-2667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215583620 | Kelly N Roundtree | Speech-Language Pathologist | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2019-08-12 |
| 1366042897 | Shelby Hancock | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-10-26 |
| 1023624525 | Sarah Elizabeth Jones | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-09-20 |
| 1306452297 | Sarah Elizabeth Gorrell | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-09-16 |
| 1760091995 | Lauren Lee | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| 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 |
|---|---|---|---|---|
| 1831741818 | Crystal Schackai | Behavior Technician | 9480 Three Rivers Rd, Gulfport, MS 39503-4248 | 2019-07-10 |
| 1033690508 | Lauren Elizabeth Zezenski | Behavior Technician | 9230 Old Lorraine Rd Ste A, Gulfport, MS 39503-6059 | 2018-08-23 |
| 1134619513 | Lora Blades | Behavior Technician | 9230 Old Lorraine Rd Unit A, Gulfport, MS 39503-6059 | 2018-05-11 |
| 1548786148 | Laura Susan Klich Henderson | Behavior Technician | 5301 18th Ave S, Gulfport, FL 33707-4216 | 2017-08-16 |
| 1366042897 | Shelby Hancock | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-10-26 |
| 1033718135 | Joanna Jones | Behavior Technician | 9480 Three Rivers Rd, Gulfport, MS 39503-4248 | 2020-10-20 |
| 1720686439 | Amelia Williams | Behavior Technician | 9480 Three Rivers Rd, Gulfport, MS 39503-4248 | 2020-10-14 |
| 1114525334 | Brooke Edmonds | Behavior Technician | 9480 Three Rivers Rd, Gulfport, MS 39503-4248 | 2020-10-09 |
| 1023624525 | Sarah Elizabeth Jones | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-09-20 |
| 1306452297 | Sarah Elizabeth Gorrell | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-09-16 |
| Find all providers in GULFPORT | ||||
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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.