Haley Goldin

Key facts

NPI

1396574802

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

License

RBT-24-364991 (FL)

Practice address

1135 Pasadena Ave S Ste 112
South Pasadena, FL 33707-2854

Phone

(727) 643-0011

NPI assigned

Aug 1, 2024

Sex

Female

Sole proprietor

Yes

Organizations & group practices 1

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.

• Applied Behavior Change Corp Behavior Analyst · Saint Petersburg, FL · NPI 1851070049
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 1, 2024.

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1396574802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 PASADENA AVE S STE 112",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337072854",
            "telephone_number": "727-643-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 PASADENA AVE S STE 112",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337072854",
            "telephone_number": "727-643-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDIN",
        "first_name": "HALEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-364991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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