NPIMap

Organization Active NPI

Holladay Child Development Services,LLC

  • Behavior Analyst
  • Lakeland, FL
National Provider Identifier
1295067593
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-04-1686 Issued in FL
Legal business name
HOLLADAY CHILD DEVELOPMENT SERVICES,LLC
Practice address
5302 S Florida Ave
Suite 202
Lakeland, FL 33813-4922
Phone
(863) 937-8067
Fax
(863) 607-6207
NPI assigned
Feb 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Joanna Marie Sitta, BCBANPI 1639691165
Title
Owner
Phone
(863) 937-8067

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-04-1686 FL Primary

Addresses

Primary practice location

5302 S Florida Ave
Suite 202
Lakeland, FL 33813-4922

Mailing address

5302 S Florida Ave
Suite 202
Lakeland, FL 33813-4922
Phone (863) 937-8067

Other identifiers 1

IdentifierTypeStateIssuer
01443200MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1295067593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 S FLORIDA AVE",
            "address_2": "SUITE 202",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338134922",
            "telephone_number": "863-937-8067",
            "fax_number": "863-607-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5302 S FLORIDA AVE",
            "address_2": "SUITE 202",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338134922",
            "telephone_number": "863-937-8067",
            "fax_number": "863-607-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLADAY CHILD DEVELOPMENT SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "SITTA",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-937-8067",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-04-1686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01443200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.