Kelsey Soubasis, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-24-349026 Issued in FL

Practice address

1750 Tree Blvd Ste 6
St Augustine, FL 32084-5719

Phone

(904) 206-7024

NPI assigned

May 22, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Allay Behavioral Therapy, LLC

  • Behavior Analyst
  • St Augustine, FL
  • NPI 1235886466
  NPD

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1679312342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 6",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-206-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 6",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-206-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUBASIS",
        "first_name": "KELSEY",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-349026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Francis Sonzogni
• James Martin Sopocy, BS
• Stuart A Soroka, M.D.
• Ivette M Sosa Seda, M.D.
• Bryan Sothoron
• Denis Sousa
• Southeast Orthopedic Specialists, Inc
• Southeast Orthopedic Specialists, Inc
• Southeast Orthopedic Specialists, LLC
• Southeast Orthopedic Specialists, LLC

• Behavior Technician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.