Active NPI
Nicole Cannella
- Behavior Technician
- Palm City, FL
National Provider Identifier
1336758259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-115823
- Practice address
- 1765 SW Captains PL
Palm City, FL 34990-1747 - Phone
- (772) 266-8727
- NPI assigned
- Jul 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-115823 | FL | Primary |
Addresses
Primary practice location
1765 SW Captains PL
Palm City, FL 34990-1747
Mailing address
172 NW Willow Grove Ave
Port St Lucie, FL 34986-3566
Phone (772) 985-8084
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-115823 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simplyaba, LLC | Current | Accepting new patients | |
| My Favorite Therapists, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Behavior Analyst
- Palm City, FL
- NPI 1306244801
-
- Behavior Analyst
- Deerfield Beach, FL
- NPI 1992153217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595808000000",
"number": "1336758259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 NW WILLOW GROVE AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349863566",
"telephone_number": "772-985-8084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1765 SW CAPTAINS PL",
"city": "PALM CITY",
"state": "FL",
"postal_code": "349901747",
"telephone_number": "772-266-8727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNELLA",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-27",
"last_updated": "2020-07-27",
"certification_date": "2020-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-20-115823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.