Active NPI
Lyza and M'Leeya Playhouse
- Behavior Technician
- Titusville, FL
National Provider Identifier
1184537243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Legal business name
- LYZA AND M'LEEYA PLAYHOUSE
- Practice address
- 1556 S Park Ave
Titusville, FL 32780-4364 - Phone
- (407) 802-7071
- NPI assigned
- Sep 28, 2026
- Last updated
- Sep 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jasmine Pough
- Title
- Owner
- Phone
- (407) 802-7071
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | NU | ||
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
1556 S Park Ave
Titusville, FL 32780-4364
Mailing address
1556 S Park Ave
Titusville, FL 32780-4364
Phone (407) 802-7071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790553600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790726400000",
"number": "1184537243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1556 S PARK AVE",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327804364",
"telephone_number": "407-802-7071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1556 S PARK AVE",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327804364",
"telephone_number": "407-802-7071"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LYZA AND M'LEEYA PLAYHOUSE",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-28",
"last_updated": "2026-09-30",
"certification_date": "2026-09-30",
"status": "A",
"authorized_official_last_name": "POUGH",
"authorized_official_first_name": "JASMINE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "407-802-7071"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Titusville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.