PROVIDENT PLACE (NPI# 1760049621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760049621 |
| Entity Type | Organization |
| Organization Name | PROVIDENT PLACE |
| Practice Address |
611 Seneca Ridge Ave N Las Vegas NV 89084-1315 |
| Practice Telephone | 7025613408 |
| Mailing Telephone | 7025613408 |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2019-05-24 |
| Authorized Official Name | KATIE SMITH (OWNER) |
| Authorized Official Telephone | 7025613408 |
| Is Organization Subpart | 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 |
|---|---|---|---|---|
| 1689028912 | Provident Place | Community/Behavioral Health | 418 Bradford Ln, Columbia, SC 29223-7131 | 2016-04-23 |
| 1558703827 | Provident Place | Intermediate Care Facility, Mentally Retarded | 20400 Ituma Rd, Apple Valley, CA 92308-4445 | 2013-07-26 |
| 1588006860 | Provident Place | Intermediate Care Facility, Mentally Retarded | 13943 Trigger Ln, Victorville, CA 92392-6333 | 2013-07-26 |
| 1508208877 | Provident Place | Intermediate Care Facility, Mentally Retarded | 15448 Mondamon Rd, Apple Valley, CA 92307-4557 | 2013-07-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Provident Place Wealth Advisor s LLC | 1 White Street, Onancock, Virginia 23417 |
| Street Address |
611 SENECA RIDGE AVE |
| City | N LAS VEGAS |
| State | NV |
| Zip Code | 89084-1315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275016677 | Donna Faye Bonner | Technician | 121 Elks Peak Ave., 121 Elks Peak Ave, N. Las Vegas, NV 89084 | 2018-09-11 |
| 1376047662 | Dolly Leticia Diaz | Technician | 7133 Weavers Pl, North Las Vegas, NV 89084 | 2018-03-21 |
| 1649771841 | May Ruth Byrd | Chore Provider | 6638 Cinnabar Coast Lane, Las Vegas, NV 89084 | 2018-02-22 |
| 1841718541 | Tori Tobin | Occupational Therapist | 2550 Nature Park Drive, Ste. 180, North Las Vegas, NV 89084 | 2017-09-01 |
| 1568989986 | Necole Ealy | Day Training/Habilitation Specialist | 6905 Auklet Ln, N Las Vegas, NV 89084 | 2017-08-25 |
| 1871031906 | Mvp Primary Care LLC | Registered Nurse | 6935-104 Aliante Parkway, #509, North Las Vegas, NV 89084 | 2017-02-09 |
| 1679932743 | Melissa Brown | Occupational Therapist | 29 Chastain Park Drive, North Las Vegas, NV 89084 | 2016-02-18 |
| 1598163636 | Taylor Briana Mitchell | Behavioral Analyst | 6929 Puetollano Drive, North Las Vegas, NV 89084 | 2014-12-05 |
| 1801229240 | Faith Thomas | Behavioral Analyst | 634 W Lava Beds Wy, North Las Vegas, NV 89084 | 2013-08-20 |
| 1497028401 | Cornell Williams | Rehabilitation Practitioner | 6616 Lavender Lilly Ln #1, N. Las Vegas, NV 89084 | 2012-02-22 |
| Find all providers in zip 89084 | ||||
| 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 |
|---|---|---|---|---|
| 1821625708 | Adrian King | Behavioral Analyst | 2580 N Rancho Ste 104 A, N Las Vegas, NV 89032-8903 | 2020-03-23 |
| 1164912010 | Latasha Burse | Behavioral Analyst | 2216 Ellis St Apt B, N Las Vegas, NV 89030-6077 | 2018-05-16 |
| 1679061733 | Mikell Adams | Behavioral Analyst | 604 Seneca Ridge Ave, N Las Vegas, NV 89084-1315 | 2018-04-24 |
| 1710489513 | Edrecka Wolridge | Behavioral Analyst | 4103 W Delhi Ave, N Las Vegas, NV 89032-3419 | 2018-03-07 |
| 1134647761 | Gamaae Danae Wright | Behavioral Analyst | 3260 Fountain Falls Way Apt #2172, N Las Vegas, NV 89032 | 2017-09-04 |
| 1851820401 | Ann Mcdowell | Behavioral Analyst | 3435 W Craig Rd Ste B, N Las Vegas, NV 89032-5116 | 2017-06-07 |
| 1841726726 | Romance Sweeting | Behavioral Analyst | 16 Sunny Day Ave, N Las Vegas, NV 89031-7804 | 2017-05-11 |
| 1447799689 | Dangelo Dorn | Behavioral Analyst | 6532 N Bruce St, N Las Vegas, NV 89086-1320 | 2017-02-21 |
| 1518406750 | Tatiana Awana | Behavioral Analyst | 5135 Camino Al Norte Ste 114, N Las Vegas, NV 89031-2390 | 2017-02-21 |
| 1457894578 | Tania R Guzman | Behavioral Analyst | 5249 Golden Melody Ln, N Las Vegas, NV 89081-4030 | 2016-11-21 |
| Find all providers in N LAS VEGAS | ||||
| City | N LAS VEGAS |
| Zip Code | 89084 |
Please comment or provide details below to improve the information on PROVIDENT PLACE.
| 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.