Mikaela Jane Smith

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-229080 Issued in CO

Practice address

1701 Park Center Dr Ste 202
Orlando, FL 32835-6235

Phone

(407) 286-2021

NPI assigned

Jan 9, 2023

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1205540846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5647 BEAR STONE RUN",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655032",
            "telephone_number": "407-866-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 PARK CENTER DR STE 202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356235",
            "telephone_number": "407-286-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MIKAELA",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": "RBT-22-229080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bbbinterventions.com",
            "affiliation": "Y",
            "affiliationName": "Building Blocks Behavior Interventions, LLC",
            "address_1": "1701 Park Center Dr Ste 202",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328356235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Smith
• Michael James Smith, BC-HIS
• Michelle Smith, REV, CHT, CBE, SBD
• Michelle Lee Brooks Smith, APRN
• Michelle Renae Smith
• Miranda N Smith
• Morgan G Smith, PA-C
• Myquel Lamont Smith
• Natasha Smith
• Neal Smith, M.D.

• Behavior Technician in Orlando, FL
• Providers in Orlando, FL by specialty
• Behavior Technician in Florida

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