Active NPI
Crystal Mike
- Behavior Technician
- Jupiter, FL
National Provider Identifier
1700316338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 839 University Blvd
Jupiter, FL 33458-3073 - Phone
- (772) 519-4119
- NPI assigned
- Jun 15, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
839 University Blvd
Jupiter, FL 33458-3073
Mailing address
122 SW Glenwood Dr
Port St Lucie, FL 34984-5026
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497484800000",
"number": "1700316338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 SW GLENWOOD DR",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349845026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "839 UNIVERSITY BLVD",
"city": "JUPITER",
"state": "FL",
"postal_code": "334583073",
"telephone_number": "772-519-4119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKE",
"first_name": "CRYSTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-15",
"last_updated": "2017-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jupiter, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.