Active NPI
Monique R Blackman, RBT, CNA
- Behavior Analyst
- Miami Gardens, FL
National Provider Identifier
1699501684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- RBT-24-375122
- Practice address
- 2379 NW 167TH St Apt 505
Miami Gardens, FL 33056-4574 - Phone
- (717) 201-1317
- NPI assigned
- Sep 9, 2024
- Last updated
- Sep 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | CNA429118 | FL | |
| Behavior Analyst | 103K00000X | RBT-24-375122 | FL | Primary |
Addresses
Primary practice location
2379 NW 167TH St Apt 505
Miami Gardens, FL 33056-4574
Mailing address
2379 NW 167TH St Apt 505
Miami Gardens, FL 33056-4574
Phone (717) 201-1317
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-24-375122 | FL | MD | Behavioral Analyst |
| CNA429118 | FL | MD | Nursing Care Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lacosta Therapy, LLC | Behavior Analyst | Past | 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, 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": "1725840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1699501684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2379 NW 167TH ST APT 505",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330564574",
"telephone_number": "717-201-1317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2379 NW 167TH ST APT 505",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330564574",
"telephone_number": "717-201-1317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMAN",
"first_name": "MONIQUE",
"middle_name": "R",
"credential": "RBT, CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-09",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "FL",
"license": "CNA429118",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "RBT-24-375122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.