Heather Blackall
Individual provider Active NPI Behavior Analyst · Trinity, FL
NPI 1306595384 · NPPES record last updated Jun 5, 2024
Key facts
- NPI
- 1306595384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-23-67793 (FL)
- Practice address
- 2228 Edelweiss Loop
Trinity, FL 34655-4945 - Phone
- (615) 507-5194
- NPI assigned
- Mar 18, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zoe Center for ABA and Development Services, LLC | Behavior Analyst | Past | Accepting new patients |
| Behavioral Health Field, Inc | Behavior Analyst | Past | Accepting new patients |
| Heartlinks ABA in LLC | Behavior Analyst | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Assistant Behavior Analyst | 106E00000X | 0-23-14396 | FL | |
| Behavior Analyst | 103K00000X | 1-23-67793 | FL | Yes |
Addresses
Primary practice location
2228 Edelweiss Loop
Trinity, FL 34655-4945
Mailing address
2228 Edelweiss Loop
Trinity, FL 34655-4945
Phone (615) 507-5194
Other providers in Trinity, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.