Stephanie Danielle Bolden, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

1140 Kyle Wood LN
Brandon, FL 33511-4850

Phone

(813) 512-1153

NPI assigned

Feb 20, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Stephanie D. Bolden Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• All Behavior Counts Therapy

  • Behavior Analyst
  • Ruskin, FL
  • NPI 1417652835
  NPD Authorized official
• Behavioral Framework, LLC

  • Community/Behavioral Health Agency
  • Rockville, MD
  • NPI 1659730307
  NPD (past)

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1639618895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 200",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465028",
            "telephone_number": "813-512-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 KYLE WOOD LN",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114850",
            "telephone_number": "813-512-1153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5454 Lithia Pinecrest Rd",
            "address_purpose": "LOCATION",
            "city": "Lithia",
            "state": "FL",
            "postal_code": "335472853",
            "country_code": "US",
            "telephone_number": "813-467-9280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "STEPHANIE",
        "middle_name": "DANIELLE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-20",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "FL",
            "license": "172V00000X",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER PROVIDER COMMUNITY HEALTH CARE WORKER",
            "identifier": "172V00000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "BOLDEN",
            "middle_name": "D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Deepali Ajitkumar Bobra, M.D.
• Syreeta Bogan, APRN
• Tyler Ross Bogus, DO
• Natalie Marie Bohatyritz, APRN
• Sharon Bolda, PTA
• James Lawrence Bolduc, DO
• Halie Boley
• Rose Bollinger
• Youstina Ibrahim Bolos, DPM
• Joanne C Bonami, LCSW

• Behavior Analyst in Brandon, FL
• Providers in Brandon, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.