NPIMap

Organization Active NPI

Children'S Choice Behavioral Services

  • Behavior Analyst
  • Lakeland, FL
National Provider Identifier
1124803416
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
CHILDREN'S CHOICE BEHAVIORAL SERVICES
Practice address
5619 Autumn Ridge Rd Apt 208
Lakeland, FL 33805-2794
Phone
(863) 934-2368
NPI assigned
Aug 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Katherine Ann Freeman, BCBANPI 1992118780
Title
Owner
Phone
(863) 934-2368

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 Primary

Addresses

Primary practice location

5619 Autumn Ridge Rd Apt 208
Lakeland, FL 33805-2794

Mailing address

5619 Autumn Ridge Rd Apt 208
Lakeland, FL 33805-2794
Phone (863) 934-2368

Other identifiers 2

IdentifierTypeStateIssuer
019767100MedicaidFL
14539706OtherFLCAQH

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": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1124803416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5619 AUTUMN RIDGE RD APT 208",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052794",
            "telephone_number": "863-934-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5619 AUTUMN RIDGE RD APT 208",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052794",
            "telephone_number": "863-934-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CHOICE BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-934-2368",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019767100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14539706",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.