Active NPI
Heather Nicole Odonnell
- Behavior Technician
- Port St Lucie, FL
National Provider Identifier
1477389187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-363772
- Practice address
- 10272 S US Highway 1
Port St Lucie, FL 34952-5615 - Phone
- (772) 872-6940
- NPI assigned
- Sep 10, 2024
- Last updated
- Sep 10, 2024
- Sex
- Female
- Sole proprietor
- No
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-24-363772 | FL | Primary |
Addresses
Primary practice location
10272 S US Highway 1
Port St Lucie, FL 34952-5615
Mailing address
4502 SW Hallmark St
Port St Lucie, FL 34953-6524
Phone (561) 294-3128
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-24-363772 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725926400000",
"number": "1477389187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4502 SW HALLMARK ST",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349536524",
"telephone_number": "561-294-3128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10272 S US HIGHWAY 1",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349525615",
"telephone_number": "772-872-6940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODONNELL",
"first_name": "HEATHER",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-10",
"last_updated": "2024-09-10",
"certification_date": "2024-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-24-363772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
- Ocamelot Dba Brooks Manor Alf
- Megan Elizabeth Ocando, LMHC
- Oceanside Home Care Solutions, LLC
- Eliette Odige
- Eva L Odonnell, SLP
- Walter Offenhartz, MD
- Oglethorpe of Port St Lucie LLC (Port St Lucie Hospital)
- Oglethorpe Psychmed Services of Florida Inc
- Ohana Adult Family Care Home, Inc.
- Noemi N Olavarria-Gardner
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.