Growing Minds Outside the Box

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

01063112 Issued in FL

Legal business name

GROWING MINDS OUTSIDE THE BOX

Practice address

3052 Highway 17
Green Cove Springs, FL 32043-9331

Phone

(850) 227-4392

NPI assigned

Jan 21, 2016

Organization subpart

No

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

Authorized official

Name

Christine Fazio, M.S.,BCBA

Title

Director

Phone

(850) 227-4392

Specialties & licenses 1

Addresses

Tax ID family

Growing Minds Outside the Box2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Growing Minds Outside the Box

  • Behavior Analyst
  • Orange Park, FL
  • NPI 1588485098
  NPD tax ID

Locations

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1245697234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3052 HIGHWAY 17",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320439331",
            "telephone_number": "850-227-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3052 HIGHWAY 17",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320439331",
            "telephone_number": "850-227-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWING MINDS OUTSIDE THE BOX",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-21",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "FAZIO",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-227-4392",
        "authorized_official_credential": "M.S.,BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "01063112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Cove Facility Operations LLC
• Regina Goodson Greenwood, LMHC
• Gregory Albrecht PA
• Desiree Griffin, LMHC
• Edward Grout, O.D.
• Tyler Hamilton, PHARMD
• Betty Harbolic, MS, RDN, BCC
• Megan A. Hartwig, OTR/L
• Kimberly Rea Hayes, PTA
• Healthy Schools, LLC

• Behavior Analyst in Green Cove Springs, FL
• Providers in Green Cove Springs, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.