Individual provider Active NPI

Monique R Blackman, RBT, CNA

  • Behavior Analyst
  • Miami Gardens, FL
National Provider Identifier
1699501684
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
RBT-24-375122 Issued in FL
Practice address
2379 NW 167TH St Apt 505
Miami Gardens, FL 33056-4574
Phone
(717) 201-1317
NPI assigned
Sep 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
RBT-24-375122FLMDBehavioral Analyst
CNA429118FLMDNursing Care Agency

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

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.

Verify at the official NPI Registry.