NPIMap

Organization Active NPI

Little Waves Viera, LLC

  • Behavior Analyst
  • Rockledge, FL
National Provider Identifier
1578397261
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
LITTLE WAVES VIERA, LLC
Practice address
767 Thrasher Dr
Rockledge, FL 32955-6305
Phone
(321) 872-8535
NPI assigned
Aug 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Jacqueline L Jackson, M.ED., BCBANPI 1861083909
Title
Founder and Executive Director
Phone
(321) 872-8535

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

767 Thrasher Dr
Rockledge, FL 32955-6305

Mailing address

767 Thrasher Dr
Rockledge, FL 32955-6305
Phone (321) 872-8535

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1724716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1578397261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 THRASHER DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329556305",
            "telephone_number": "321-872-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 THRASHER DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329556305",
            "telephone_number": "321-872-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE WAVES VIERA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "FOUNDER AND EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-872-8535",
        "authorized_official_credential": "M.ED., BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.