Individual provider Active NPI

Jerrica Love

  • Behavior Technician
  • Melbourne, FL
National Provider Identifier
1043073349
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2226 Sarno Rd Ste 100
Melbourne, FL 32935-3087
Phone
(321) 313-4804
NPI assigned
Jan 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

2226 Sarno Rd Ste 100
Melbourne, FL 32935-3087

Mailing address

2226 Sarno Rd Ste 100
Melbourne, FL 32935-3087
Phone (321) 313-4804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Space Coast Behavior Analysis LLC CurrentSince Feb 4, 2024 Accepting new patients

Locations

2226 Sarno Rd
Ste 100
Melbourne, FL 32935
Phone (321) 313-4804

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1043073349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 SARNO RD STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353087",
            "telephone_number": "321-313-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 SARNO RD STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353087",
            "telephone_number": "321-313-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE",
        "first_name": "JERRICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.