Individual provider Active NPI

Crystal Caceres

  • Behavior Analyst
  • Doral, FL
National Provider Identifier
1215340641
Registry record updated Apr 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-40544 Issued in FL
Practice address
7875 NW 12TH St Ste 109
Doral, FL 33126-1815
Phone
(786) 269-3502
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-20-40544 FL Primary

Addresses

Primary practice location

7875 NW 12TH St Ste 109
Doral, FL 33126-1815

Mailing address

10045 NW 28TH Ter
Doral, FL 33172-1333
Phone (786) 447-2175

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Minds Psychological Services CurrentSince May 17, 2020 Accepting new patients
Mindful Minds ABA Solutions LLC Behavior Analyst CurrentSince Feb 4, 2024 Accepting new patients

Locations

7875 NW 12th St
Ste 109
Doral, FL 33126
Phone (786) 269-3502

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587859200000",
    "number": "1215340641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10045 NW 28TH TER",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331721333",
            "telephone_number": "786-447-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7875 NW 12TH ST STE 109",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261815",
            "telephone_number": "786-269-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACERES",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2020-04-26",
        "certification_date": "2020-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-20-40544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2020; 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.