Active NPI
Victoria Haynes
- Assistant Behavior Analyst
- Tampa, FL
National Provider Identifier
1124625397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- 0-22-13962
- Practice address
- 1413 Tech Blvd Ste 122
Tampa, FL 33619-7822 - Phone
- (855) 832-6727
- NPI assigned
- Oct 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-134270 | FL | |
| Assistant Behavior Analyst | 106E00000X | 0-22-13962 | FL | Primary |
Addresses
Primary practice location
1413 Tech Blvd Ste 122
Tampa, FL 33619-7822
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-134270 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountainside Behavior Analysis Services, LCC | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Davis, WV
- NPI 1225574544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1124625397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1413 TECH BLVD STE 122",
"city": "TAMPA",
"state": "FL",
"postal_code": "336197822",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "VICTORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-01",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-20-134270",
"primary": false
},
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "FL",
"license": "0-22-13962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.