Active NPI
Olnique Desir
- Behavior Technician
- West Palm Beach, FL
National Provider Identifier
1194379693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-72845
- Practice address
- 625 High St
West Palm Beach, FL 33405-1528 - Phone
- (561) 560-0064
- Fax
- (561) 560-0062
- NPI assigned
- Aug 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-72845 | FL | Primary |
Addresses
Primary practice location
625 High St
West Palm Beach, FL 33405-1528
Mailing address
2400 SE Federal Hwy Ste 220
Stuart, FL 34994-4556
Phone (772) 678-6704
Other practice location 1
2400 SE Federal Hwy Ste 220
Stuart, FL 34994-4556
Phone (772) 678-6704
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018163300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-72845 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kokoro Care Network, LLC | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- West Palm Beach, FL, FL
- NPI 1306410782
Behavior Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646956800000",
"number": "1194379693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 SE FEDERAL HWY STE 220",
"city": "STUART",
"state": "FL",
"postal_code": "349944556",
"telephone_number": "772-678-6704",
"fax_number": "772-221-9969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 HIGH ST",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334051528",
"telephone_number": "561-560-0064",
"fax_number": "561-560-0062"
}
],
"practiceLocations": [
{
"address_1": "2400 SE Federal Hwy Ste 220",
"address_purpose": "LOCATION",
"city": "Stuart",
"state": "FL",
"postal_code": "349944556",
"country_code": "US",
"telephone_number": "772-678-6704",
"fax_number": "772-221-9969",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DESIR",
"first_name": "OLNIQUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-01",
"last_updated": "2022-03-11",
"certification_date": "2022-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-18-72845",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "018163300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.