Individual provider Active NPI

Courtney Arbildo, BCBA

  • Behavior Analyst
  • Pembroke Pines, FL
National Provider Identifier
1649763467
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-77083
Practice address
17773 SW 2ND St
Pembroke Pines, FL 33029-3924
Phone
(954) 589-2347
NPI assigned
Jun 7, 2018
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-24-77083 Primary
Assistant Behavior Analyst 106E00000X QASP9858 GA
Behavior Technician 106S00000X RBT-16-21026

Addresses

Primary practice location

17773 SW 2ND St
Pembroke Pines, FL 33029-3924

Mailing address

16895 NE 4TH PL
North Miami Beach, FL 33162-3965
Phone (863) 640-2995

Other identifiers 1

IdentifierTypeStateIssuer
9000178498MedicaidCO

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
QASP9858GAMDAssistant Behavior Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Evolving Minds Together LLC CurrentSince Nov 24, 2024 Accepting new patients
Nurture Home Health Care Inc PastSince Nov 1, 2020 Accepting new patients
Wellcare Inc. Behavior Analyst PastSince Nov 1, 2020 Accepting new patients

Locations

17773 SW 2nd St
Pembroke Pines, FL 33029
Phone (954) 589-2347

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1649763467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16895 NE 4TH PL",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623965",
            "telephone_number": "863-640-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17773 SW 2ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293924",
            "telephone_number": "954-589-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARBILDO",
        "first_name": "COURTNEY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-24-77083",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "GA",
            "license": "QASP9858",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-16-21026",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000178498",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.