The Arc of the St. Johns

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0-13-5635 Issued in FL

Legal business name

THE ARC OF THE ST. JOHNS

Practice address

2101 Arc Dr
St Augustine, FL 32084-0512

Phone

(386) 846-8407

NPI assigned

Mar 11, 2014

Last updated

Mar 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lori Ann Bolt, BCBANPI 1346527793

Title

Senior Behavior Analyst

Phone

(904) 824-7249

Specialties & licenses 1

Addresses

Tax ID family

The Arc of the St Johns Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• The Arc of the St Johns

  • Adult Day Care Clinic/Center
  • St Augustine, FL
  • NPI 1699597880
  NPD tax ID
• The Arc of the St Johns, Inc.

  • Community/Behavioral Health Agency
  • St Augustine, FL
  • NPI 1568536274
  NPD tax ID

Practitioners 1

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.

• Lori Ann Bolt, BCBA

  • Behavior Analyst
  • St Augustine, FL
  • NPI 1346527793
  Authorized official Same address or phone

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1487070744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 ARC DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840512",
            "telephone_number": "386-846-8407",
            "fax_number": "904-824-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ARC DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840512",
            "telephone_number": "386-846-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ARC OF THE ST. JOHNS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "BOLT",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SENIOR BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "904-824-7249",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "0-13-5635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Dawn Terry, PHARM D
• Alyssa A Thaxton, LCSW
• The Apollo Group International, Inc
• The Arc of the St Johns
• The Arc of the St Johns, Inc.
• The Arc of the St. Johns, Inc.
• The Best Dentist in Saint Augustine PLLC
• The Brighter Side of Life LLC
• The Canopy at Wellbeing
• The Kadie Group, Inc

• Behavior Analyst in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.