Pediatric Behavioral Services

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

PEDIATRIC BEHAVIORAL SERVICES

Practice address

4160 Oceanside St
North Port, FL 34286-2014

Phone

(863) 529-2183

NPI assigned

Feb 19, 2019

Organization subpart

No

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

Authorized official

Name

Stacy Landry, BCBANPI 1164748885

Title

Behavior Analyst

Phone

(863) 529-2183

Specialties & licenses 1

Addresses

Practitioners 1

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

• Stacy Landry

  • Behavior Analyst
  • Kissimmee, FL
  • NPI 1164748885
  NPD (past) Authorized official

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575504000000",
    "number": "1144786773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 OCEANSIDE ST",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342862014",
            "telephone_number": "863-529-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 OCEANSIDE ST",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342862014",
            "telephone_number": "863-529-2183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3659 Victoria Manor Dr Apt 212",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338050003",
            "country_code": "US",
            "telephone_number": "954-594-1850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEDIATRIC BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-12-05",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "863-529-2183",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathways Counseling LLC
• Madison Paul
• Paulines Phlebotomy Services Inc (NorthPort Blood Draw)
• Paxton Medical Management (Family Doctors of North Port)
• Wendy Pazos
• Kelsi Pedigo
• Brianna Peery
• Sabrina A Penny
• Melany Alicia Perez de la Vega
• Pedro Perez

• Behavior Analyst in North Port, FL
• Providers in North Port, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.