Active NPI
Carole Anne Basel
- Developmental Therapist
- Laurel Hill, FL
National Provider Identifier
1639795347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 6562 Welannee Blvd
Laurel Hill, FL 32567-7311 - Phone
- (805) 588-2575
- NPI assigned
- Jun 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
6562 Welannee Blvd
Laurel Hill, FL 32567-7311
Mailing address
6562 Welannee Blvd
Laurel Hill, FL 32567-7311
Phone (805) 588-2575
Other practice location 1
2836 Pear Orchard Blvd
Crestview, FL 32539-5612
Phone (805) 588-2575
Other practice location 2
Emerald Coast Behavior Inc
8418 E Bay Blvd
Navarre, FL 32566
Phone (850) 307-8811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109181800 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1639795347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6562 WELANNEE BLVD",
"city": "LAUREL HILL",
"state": "FL",
"postal_code": "325677311",
"telephone_number": "805-588-2575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6562 WELANNEE BLVD",
"city": "LAUREL HILL",
"state": "FL",
"postal_code": "325677311",
"telephone_number": "805-588-2575"
}
],
"practiceLocations": [
{
"address_1": "2836 Pear Orchard Blvd",
"address_purpose": "LOCATION",
"city": "Crestview",
"state": "FL",
"postal_code": "325395612",
"country_code": "US",
"telephone_number": "805-588-2575",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Emerald Coast Behavior Inc",
"address_2": "8418 E Bay Blvd",
"address_purpose": "LOCATION",
"city": "Navarre",
"state": "FL",
"postal_code": "32566",
"country_code": "US",
"telephone_number": "850-307-8811",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BASEL",
"first_name": "CAROLE",
"middle_name": "ANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-18",
"last_updated": "2021-06-22",
"certification_date": "2021-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109181800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Laurel Hill, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.