THERESA L MACK (NPI# 1922520006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922520006 |
| Entity Type | Individual |
| Full Name | THERESA L MACK |
| Credential | BEHAVIOR TECHNICIAN |
| Practice Address |
2733 21st Avenue Sw Largo FL 33774-3377 |
| Mailing Address |
2733 21st Avenue Sw Largo FL 33774 |
| Practice Telephone | 7277449755 |
| Mailing Telephone | 7277449755 |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2017-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 674572 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700171378 | Theresa Mack | Licensed Practical Nurse | 394 Electric Ave, Rochester, NY 14613-1004 | 2011-06-12 |
| 1215953047 | Theresa Mack | Internal Medicine | 1111 Amsterdam Ave, New York, NY 10025-1716 | 2006-07-14 |
| Street Address |
2733 21ST AVENUE SW |
| City | LARGO |
| State | FL |
| Zip Code | 33774-3377 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467930818 | Anthea Marina Dsouza | Physical Therapist | 3500 Oak Manor Lane, Largo, FL 33774 | 2018-07-29 |
| 1265918874 | Bertishia Lashanti Mosley | Home Health | 2308 Fulton Way, Largo, FL 33774 | 2018-07-17 |
| 1639660699 | Tanya Jadhav | Dentist | 12963 Walsingham Rd, Largo, FL 33774 | 2018-05-25 |
| 1588001390 | Lindsay Erin Spotts | Dietitian, Registered | 14763 Sunset Drive, Largo, FL 33774 | 2013-06-03 |
| 1235572314 | Jasmine Gardens LLC | Assisted Living Facility | 11355 131st St, Largo, FL 33774 | 2013-04-09 |
| 1033484183 | The Body Masters, Inc | Massage Therapist | 12552 Indian Rocks Road, Largo, FL 33774 | 2012-03-21 |
| 1902112923 | Christie Youssef | Family Medicine | 2025 Indian Rocks Rd., Largo, FL 33774 | 2010-08-27 |
| 1568777548 | Lee Laravia | General Practice | 2025 Indian Rocks Rd, Largo, FL 33774 | 2010-08-13 |
| 1699957068 | Indian Oaks Incorporated | Assisted Living Facility | 11355 131st Street North, Largo, FL 33774 | 2007-11-28 |
| 1487867164 | Eric Nathan Grosch | Internal Medicine | 11800 Hammock Drive, Largo, FL 33774 | 2007-05-08 |
| Find all providers in zip 33774 | ||||
| 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 |
|---|---|---|---|---|
| 1700498151 | Christine Colon | Behavior Technician | 11474 119th Ter, Largo, FL 33778-2531 | 2020-08-18 |
| 1659858751 | Rachel Knapp | Behavior Technician | 7381 114th Avenue, Ste 405, Largo, FL 33773-5023 | 2018-07-23 |
| 1851805923 | Catherine Rosa | Behavior Technician | 11711 Leisure Ln E, Largo, FL 33773-4752 | 2017-11-27 |
| 1043737109 | Keleigh E Devlin | Behavior Technician | 12505 Starkey Road, Suite G, Largo, FL 33776 | 2017-08-29 |
| 1609315910 | Dominique J Clark | Behavior Technician | 11216 108th Way, Largo, FL 33778-3320 | 2017-02-20 |
| 1336740133 | Jourdan Rapaport | Behavior Technician | 12505 Starkey Rd Ste K, Largo, FL 33773-2617 | 2020-11-06 |
| 1245830959 | Brian Hasten | Behavior Technician | 12505 Starkey Rd Ste K, Largo, FL 33773-2617 | 2020-10-30 |
| 1457950602 | Elena Sakosky | Behavior Technician | 12505 Starkey Rd Ste K, Largo, FL 33773-2617 | 2020-10-20 |
| 1326646001 | Mackenzie Hodge | Behavior Technician | 12505 Starkey Rd Ste K, Largo, FL 33773-2617 | 2020-10-14 |
| 1831796176 | Larissa Gray | Behavior Technician | 12505 Starkey Rd Ste K, Largo, FL 33773-2617 | 2020-10-08 |
| Find all providers in LARGO | ||||
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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.