Stormie Harwood – Behavior Technician

Key facts

NPI: 1669049110
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Technician 106S00000X
Practice address: 997 Atlantic Blvd
Atlantic Beach, FL 32233-3311
Phone: (904) 647-1849
Fax: (904) 647-2625
NPI assigned: Jun 4, 2021
Sex: Female
Sole proprietor: No

Organizations & group practices 2

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.

Bloom Behavioral Solutions Multi-Specialty Clinic/Center · Atlantic Beach, FL · NPI 1780088609

NPD
Bloom Behavioral Solutions, Inc. Multi-Specialty Clinic/Center · Atlantic Beach, FL · NPI 1881953347

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Bloom Behavioral Solutions, Inc.		Current since Jan 19, 2025	Accepting new patients
Bloom Behavioral Solutions		Current since Jan 19, 2025	Accepting new patients

Locations

997 Atlantic Blvd
Jacksonville, FL 32233
Phone (904) 647-1849

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X			Yes

Addresses

Primary practice location

997 Atlantic Blvd
Atlantic Beach, FL 32233-3311

Mailing address

997 Atlantic Blvd
Atlantic Beach, FL 32233-3311
Phone (904) 647-1849

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 4, 2021.

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1669049110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 ATLANTIC BLVD",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322333311",
            "telephone_number": "904-647-1849",
            "fax_number": "904-647-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 ATLANTIC BLVD",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322333311",
            "telephone_number": "904-647-1849",
            "fax_number": "904-647-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARWOOD",
        "first_name": "STORMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic Beach, FL

All providers in Atlantic Beach, FL · Behavior Technician in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.