Amanda Rudd Bonnell

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-16-24732 Issued in FL

Practice address

823 Dunlawton Ave Ste a
Port Orange, FL 32127-4221

Phone

(877) 823-4283

NPI assigned

Nov 19, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Adapt Behavioral Services, Inc.

  • Community/Behavioral Health Agency
  • Maitland, FL
  • NPI 1356532584

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1154728194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 PEACHTREE RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 DUNLAWTON AVE STE A",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274221",
            "telephone_number": "877-823-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNELL",
        "first_name": "AMANDA",
        "middle_name": "RUDD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-19",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-16-24732",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Bolte, DC
• Tyler Bolvin, RBT
• Alicia Bommarito
• Jenna Rose Bonaccorso, DO
• Julie Tessler Bonamo, OTR/L, CHT
• Brenda Bookspan
• Samantha Boolman
• Hannah Elayna Bornamann, ATC
• Carrie Bose
• Yashauna Bosley

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.

Verify at the official NPI Registry.