Evner Behavior Services, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

EVNER BEHAVIOR SERVICES, LLC

Practice address

12350 Shore Acres Dr
Jacksonville, FL 32225-5670

Phone

(770) 500-8137

NPI assigned

Sep 16, 2021

Organization subpart

No

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

Authorized official

Name

Courtney Rollings Latham, M.ED, BCBANPI 1548732886

Title

Owner/Bcba

Phone

(770) 500-8137

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

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

• Courtney Rollings Latham, BCBA

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1548732886
  NPD Authorized official

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1134899685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12350 SHORE ACRES DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322255670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12350 SHORE ACRES DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322255670",
            "telephone_number": "770-500-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVNER BEHAVIOR SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "ROLLINGS LATHAM",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "OWNER/BCBA",
        "authorized_official_telephone_number": "770-500-8137",
        "authorized_official_credential": "M.ED, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "evnerbehaviorservices@gmail.com",
            "affiliation": "N",
            "address_1": "12350 Shore Acres Dr",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322255670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Analyst in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.