Active NPI
Kioko Mitchell
- Behavior Technician
- Lutz, FL
National Provider Identifier
1417890609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 2904 Network PL Apt 203D
Lutz, FL 33559-3174 - Phone
- (706) 373-6469
- NPI assigned
- Apr 13, 2026
- 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 | Primary |
Addresses
Primary practice location
2904 Network PL Apt 203D
Lutz, FL 33559-3174
Mailing address
2904 Network PL Apt 203D
Lutz, FL 33559-3174
Phone (706) 373-6469
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776038400000",
"number": "1417890609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2904 NETWORK PL APT 203D",
"city": "LUTZ",
"state": "FL",
"postal_code": "335593174",
"telephone_number": "706-373-6469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2904 NETWORK PL APT 203D",
"city": "LUTZ",
"state": "FL",
"postal_code": "335593174",
"telephone_number": "706-373-6469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "KIOKO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-04-13",
"last_updated": "2026-04-13",
"certification_date": "2026-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.