Individual provider Active NPI

Princenella Casado

  • Behavior Technician
  • Stuart, FL
National Provider Identifier
1679211585
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-21-173676 Issued in FL
Practice address
821 SE Ocean Blvd Ste Bandc
Stuart, FL 34994-2456
Phone
(772) 872-6940
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-21-173676 FL Primary

Addresses

Primary practice location

821 SE Ocean Blvd Ste Bandc
Stuart, FL 34994-2456

Mailing address

3344 NE Sandra Dr
Jensen Beach, FL 34957-3972

Other identifiers 1

IdentifierTypeStateIssuer
111311500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address princenella@cbgaba.com Direct

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
RBT-21-173676FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Nicole Vendette, LLC PastSince May 29, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1679211585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3344 NE SANDRA DR",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 SE OCEAN BLVD STE BANDC",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942456",
            "telephone_number": "772-872-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASADO",
        "first_name": "PRINCENELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-21-173676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111311500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "princenella@cbgaba.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "821 SE Ocean Blvd Ste Bandc",
            "city": "Stuart",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349942456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.