Individual provider Active NPI

Swanylda Stewart Villiva

  • Behavior Technician
  • Naples, FL
National Provider Identifier
1508515974
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
20-121507 Issued in FL
Practice address
4617 43Rd Ave NE
Naples, FL 34120-1591
Phone
(786) 720-6170
NPI assigned
Mar 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 20-121507 FL Primary

Addresses

Primary practice location

4617 43Rd Ave NE
Naples, FL 34120-1591

Mailing address

4617 43Rd Ave NE
Naples, FL 34120-1591
Phone (786) 720-6170

Other identifiers 1

IdentifierTypeStateIssuer
107552800MedicaidFL

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

LicenseStateTypeSpecialty
20-121507FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1508515974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 43RD AVE NE",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341201591",
            "telephone_number": "786-720-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 43RD AVE NE",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341201591",
            "telephone_number": "786-720-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART VILLIVA",
        "first_name": "SWANYLDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "20-121507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107552800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.

Verify at the official NPI Registry.