Individual provider Active NPI

Marie Georgia Jeanjacques Etienne

  • Behavior Technician
  • Delray Beach, FL
National Provider Identifier
1063263200
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5850 Atlantic Ave Ste 112
Delray Beach, FL 33484-8427
Phone
(561) 336-0358
NPI assigned
Mar 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

5850 Atlantic Ave Ste 112
Delray Beach, FL 33484-8427

Mailing address

1935 S Federal Hwy
Boynton Beach, FL 33435-6967
Phone (561) 327-7158

Other practice location 1

310 SW 10th Ave
Boynton Beach, FL 33435-5926
Phone (561) 396-0196

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

NPI Registry JSON

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1063263200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 S FEDERAL HWY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334356967",
            "telephone_number": "561-327-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 ATLANTIC AVE STE 112",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848427",
            "telephone_number": "561-336-0358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 SW 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334355926",
            "country_code": "US",
            "telephone_number": "561-396-0196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEANJACQUES ETIENNE",
        "first_name": "MARIE GEORGIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-27",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.