Dominique Giese, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BACB-0-25-84988

Practice address

4100 S Ferdon Blvd
Crestview, FL 32536-5252

Phone

(850) 632-6824

Fax

(850) 602-6932

NPI assigned

Feb 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• New Leaf Behavioral Support LLC

  • Behavior Analyst
  • Crestview, FL
  • NPI 1851253322
  NPD Authorized official
• Beyond Expectations Inc.

  • Behavior Analyst
  • Crestview, FL
  • NPI 1619644069
  NPD
• Springfield Arc, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Springfield, IL
  • NPI 1295865350
  NPD (past)

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1497387807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 S FERDON BLVD STE B3",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365287",
            "telephone_number": "850-362-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S FERDON BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365252",
            "telephone_number": "850-632-6824",
            "fax_number": "850-602-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIESE",
        "first_name": "DOMINIQUE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "BACB-0-25-84988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genoa Healthcare LLC
• Katilyn Nicole Geohagan
• Diana Gibbs
• Jessica Ann Gibson, MSN, CNM, ARNP
• Monica Gibson
• Johnny Givens
• Sarah Danielle Givens, LPN
• Mindi Joy Godfrey
• Madelyn Goergen
• Cornisha Goldsmith

• Behavior Analyst in Crestview, FL
• Providers in Crestview, 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 22, 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.