NPIMap

Organization Active NPI

Emerald Coast Autism Center

  • Behavior Analyst
  • Valparaiso, FL
National Provider Identifier
1194132514
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11416693 Issued in FL
Legal business name
EMERALD COAST AUTISM CENTER
Practice address
315 Edge Ave
Valparaiso, FL 32580-1807
Phone
(850) 279-3000
Fax
(850) 389-2269
NPI assigned
Jul 17, 2014
Last updated
Jul 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Miss Jessica A Youra, BCBA
Title
Behavior Therapist
Phone
(850) 279-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 11416693 FL Primary

Addresses

Primary practice location

315 Edge Ave
Valparaiso, FL 32580-1807

Mailing address

315 Edge Ave
Valparaiso, FL 32580-1807
Phone (850) 279-3000

National Provider Directory

National Provider Directory
Tax ID family
Emerald Coast Autism Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

315 Edge Ave
Valparaiso, FL 32580
Phone (850) 279-3000

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1194132514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 EDGE AVE",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "325801807",
            "telephone_number": "850-279-3000",
            "fax_number": "850-389-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 EDGE AVE",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "325801807",
            "telephone_number": "850-279-3000",
            "fax_number": "850-389-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST AUTISM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "YOURA",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BEHAVIOR THERAPIST",
        "authorized_official_telephone_number": "850-279-3000",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "11416693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.