NPIMap

Organization Active NPI

Intensive Behavior Supports

  • Behavior Analyst
  • Palm Harbor, FL
National Provider Identifier
1073960993
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1000169 Issued in FL
Legal business name
INTENSIVE BEHAVIOR SUPPORTS
Practice address
90 Citrus CT
Palm Harbor, FL 34683-3702
Phone
(727) 744-9829
NPI assigned
May 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Authorized official

Name
Tamara Nenni, BCBANPI 1184071094
Title
Owner
Phone
(727) 744-9829

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1000169 FL Primary

Addresses

Primary practice location

90 Citrus CT
Palm Harbor, FL 34683-3702

Mailing address

90 Citrus CT
Palm Harbor, FL 34683-3702
Phone (727) 744-9829

Other identifiers 1

IdentifierTypeStateIssuer
011132200OtherFLMEDICAID WAIVER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1073960993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CITRUS CT",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346833702",
            "telephone_number": "727-744-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CITRUS CT",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346833702",
            "telephone_number": "727-744-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENSIVE BEHAVIOR SUPPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "NENNI",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-744-9829",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1000169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WAIVER",
            "identifier": "011132200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.