NPIMap

Organization Active NPI

Behavioral and Life Connections

Doing business as B L C

  • Behavior Analyst
  • Panama City Beach, FL
National Provider Identifier
1457946238
Registry record updated Jan 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BEHAVIORAL AND LIFE CONNECTIONS
Doing business as
B L C
Practice address
8219 Front Beach Rd Ste B # 2148
Panama City Beach, FL 32407-4822
Phone
(850) 427-3079
NPI assigned
Mar 4, 2021
Last updated
Jan 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2025

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

Authorized official

Name
Deaundra JacksonNPI 1013368026
Title
Member
Phone
(850) 427-3079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

8219 Front Beach Rd Ste B # 2148
Panama City Beach, FL 32407-4822

Mailing address

PO Box 5812
Marianna, FL 32447-5812

Other names 1

  • B L C Doing business as

National Provider Directory

National Provider Directory

Locations

2031 Hope School Dr
Marianna, FL 32448

7940 Front Beach Rd
#2148
Panama City Beach, FL 32407

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736035200000",
    "number": "1457946238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5812",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324475812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8219 FRONT BEACH RD STE B # 2148",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324074822",
            "telephone_number": "850-427-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL AND LIFE CONNECTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DEAUNDRA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "850-427-3079"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "B L C",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "B L C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2025; 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.