NPIMap

Organization Active NPI

Family Behavioral Support

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1487024535
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-09-5608 Issued in FL
Legal business name
FAMILY BEHAVIORAL SUPPORT
Practice address
12665 White Cedar TRL
Jacksonville, FL 32226-5032
Phone
(904) 535-0660
NPI assigned
Oct 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Kristen Duffney, MS, BCBANPI 1750672333
Title
President
Phone
(904) 535-0660

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103K00000X 1-09-5608 FL Primary
Assistant Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106E00000X 0-13-5622 FL
Behavior TechnicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106S00000X RBT-15-02211 FL

Addresses

Primary practice location

12665 White Cedar TRL
Jacksonville, FL 32226-5032

Mailing address

12665 White Cedar TRL
Jacksonville, FL 32226-5032
Phone (904) 535-0660

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1487024535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 WHITE CEDAR TRL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322265032",
            "telephone_number": "904-535-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 WHITE CEDAR TRL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322265032",
            "telephone_number": "904-535-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY BEHAVIORAL SUPPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "DUFFNEY",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-535-0660",
        "authorized_official_credential": "MS, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-09-5608",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-13-5622",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-15-02211",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.