Mary Ruth Woodall, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-77490 Issued in FL

Practice address

7552 Navarre Pkwy Unit 32
Navarre, FL 32566-7308

Phone

(850) 939-3944

NPI assigned

Aug 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1285300079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7552 NAVARRE PKWY UNIT 32",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667308",
            "telephone_number": "850-939-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7552 NAVARRE PKWY UNIT 32",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667308",
            "telephone_number": "850-939-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "MARY",
        "middle_name": "RUTH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "13435",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-21-179915",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-24-77490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Bernard Windfelder Jr., PA-C
• Andrea H Wingett
• Allison Wolbert, MS CCC-SLP
• Ryan D Wolf, RCSWI
• Katy Wolfe
• William Allen Woodall Jr., LMHC
• Aleah Marie Woods
• Wendy Ellen Worden, LMT
• Deneb Wright, APRN
• Chelsea Younger

• Behavior Analyst in Navarre, FL
• Providers in Navarre, 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 19, 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.