Caitlin Austin Mangum

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

166 A1A N
Ponte Vedra Beach, FL 32082-5701

Phone

(904) 434-6351

NPI assigned

Dec 26, 2017

Last updated

Oct 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nocal Behavioral Services LLC

  • Behavior Analyst
  • Ponte Vedra, FL
  • NPI 1184084782
  NPD (past)

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1497261697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 A1A N",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 A1A N",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825701",
            "telephone_number": "904-434-6351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 A1A N",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra Beach",
            "state": "FL",
            "postal_code": "320825701",
            "country_code": "US",
            "telephone_number": "904-434-6351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "CAITLIN",
        "middle_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-26",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smita Malhotra, DPM
• Dawn A. Mallard, MA CCC-SLP
• Jennifer Marie Mallis, MSW, LCSW, QS
• Mandala Family Wellness LLC
• Mandala Family Wellness LLC
• Marilyn Bosworth, SLP
• Nancy Ann Marin, OTR L
• Carly Brooke Mariotti
• William Francis Maroney, DDS
• Shelley Marsh, SLP

• Behavior Analyst in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.