Individual provider Active NPI

Mairelys Concepcion, RBT

  • Behavior Technician
  • Lehigh Acres, FL
National Provider Identifier
1245732387
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-124181 Issued in FL
Practice address
621 Willard Ave
Lehigh Acres, FL 33972-7930
Phone
(786) 317-0100
NPI assigned
Mar 5, 2018
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-20-124181 FL Primary

Addresses

Primary practice location

621 Willard Ave
Lehigh Acres, FL 33972-7930

Mailing address

621 Willard Ave
Lehigh Acres, FL 33972-7930
Phone (786) 317-0100

Other practice location 1

714 McArthur Ave
Lehigh Acres, FL 33936-1214
Phone (786) 317-0100

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

LicenseStateTypeSpecialty
RBT-20-124181FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige ABA Services LLC CurrentSince Aug 4, 2024 Accepting new patients
Prestige ABA Services LLC CurrentSince Jan 26, 2025 Accepting new patients
Prestige ABA Services LLC PastSince Jun 8, 2025 Accepting new patients

Locations

4350 Fowler St
Ste 3
Fort Myers, FL 33901
Phone (786) 317-0100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1245732387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 WILLARD AVE",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339727930",
            "telephone_number": "786-317-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 WILLARD AVE",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339727930",
            "telephone_number": "786-317-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "714 McArthur Ave",
            "address_purpose": "LOCATION",
            "city": "Lehigh Acres",
            "state": "FL",
            "postal_code": "339361214",
            "country_code": "US",
            "telephone_number": "786-317-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "MAIRELYS",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-124181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.