Active NPI
Ivania Nicole Mairena, RBT
- Behavior Technician
- Port Saint Lucie, FL
National Provider Identifier
1659168920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-25-403893
- Practice address
- 4142 SW Bamberg St
Port Saint Lucie, FL 34953-6113 - Phone
- (772) 985-7680
- NPI assigned
- Apr 21, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-25-403893 | FL | Primary |
Addresses
Primary practice location
4142 SW Bamberg St
Port Saint Lucie, FL 34953-6113
Mailing address
3461 SE Willoughby Blvd
Stuart, FL 34994-5060
Phone (772) 600-8843
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-25-403893 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745193600000",
"number": "1659168920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3461 SE WILLOUGHBY BLVD",
"city": "STUART",
"state": "FL",
"postal_code": "349945060",
"telephone_number": "772-600-8843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4142 SW BAMBERG ST",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349536113",
"telephone_number": "772-985-7680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAIRENA",
"first_name": "IVANIA",
"middle_name": "NICOLE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-21",
"last_updated": "2025-04-21",
"certification_date": "2025-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-25-403893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.