Tina M Smith, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-01-0572 Issued in FL

Practice address

2226 Sarno Rd Ste 100
Melbourne, FL 32935-3087

Phone

(321) 313-4804

NPI assigned

Jan 23, 2009

Last updated

Mar 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Space Coast Behavior Analysis LLC

  • Behavior Analyst
  • Melbourne, FL
  • NPI 1750007886
  NPD Authorized official

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1174761563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 LYTTON RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329349015",
            "telephone_number": "321-313-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 SARNO RD STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353087",
            "telephone_number": "321-313-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TINA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-01-0572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ross H Smith, DMD
• Sarah Smith
• Steven Done Smith, DMD
• Tannis Smith, APRN
• Terriee Smith, MS
• Vicki Risko Smith, APRN
• Victoria Ciarra Delane Smith, APRN
• Thomas Smura
• Hannah Smyth, LCMHC
• Kassandra Smythe

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.