Ernisha M Sistrunk, BCABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0-19-10172 Issued in FL

Practice address

6816 Southpoint Pkwy Ste 202
Jacksonville, FL 32216-1701

Phone

(904) 419-7792

NPI assigned

Oct 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Beacon Pediatric Behavioral Health

  • Psychologist
  • Jacksonville, FL
  • NPI 1770838872
  NPD (past)

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1275175408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 ORTEGA PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322444525",
            "telephone_number": "904-554-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6816 SOUTHPOINT PKWY STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161701",
            "telephone_number": "904-419-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISTRUNK",
        "first_name": "ERNISHA",
        "middle_name": "M",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-19-10172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Caroline Sisco, PA-C
• Kayla Sisson, PT, DPT
• Sisters With It Care and Links
• Sisters With Love Home Health LLC
• Alexis Makhya Sistrunk
• Krista Rae Sitler, ATC
• Rex Kamlung Siu, MD
• Sivanta J Paul MD PA
• Denise M. Six, DMD
• Zachary Aaron Six

• Assistant Behavior Analyst in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Assistant Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.