Naheelah S Wallace, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

21-154350 Issued in FL

Practice address

7875 NW 12TH St Ste 109
Doral, FL 33126-1815

Phone

(786) 269-3502

Fax

(305) 468-6154

NPI assigned

Mar 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Crystal Minds Psychological Services

  • Psychologist
  • Doral, FL
  • NPI 1316408180
  NPD
• Minds in Motion ABA Therapy Center LLC

  • Behavior Analyst
  • Boca Raton, FL
  • NPI 1780215665
  NPD (past)

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1447845896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6678 CONCH CT",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373651",
            "telephone_number": "772-204-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7875 NW 12TH ST STE 109",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261815",
            "telephone_number": "786-269-3502",
            "fax_number": "305-468-6154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9070 Kimberly Blvd Ste 19-20",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334342855",
            "country_code": "US",
            "telephone_number": "917-763-0885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "NAHEELAH",
        "middle_name": "S",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "21-154350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Waldo Acebo MD PA
• Walgreen Co
• Kimberlyn Walker
• Warby Parker Inc.
• Ashley Wardlow
• Sarah Waters
• John Paul Watson
• Ramona Watson

• Behavior Technician in Doral, FL
• Providers in Doral, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.