Alexandra Boulanger, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

528 Cecil G Costin Sr Blvd, Suite a
Port St Joe, FL 32456-3245

Phone

(850) 227-1163

NPI assigned

Jan 25, 2021

Last updated

Jan 25, 2021By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shoreline Center for Exceptional Students, LLC

  dba Shoreline Center

  • Behavior Analyst
  • Port St Joe, FL
  • NPI 1891303244
  NPD

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1710577663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 CECIL G COSTIN SR BLVD STE A",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324561754",
            "telephone_number": "850-227-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 CECIL G COSTIN SR BLVD, SUITE A",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324563245",
            "telephone_number": "850-227-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULANGER",
        "first_name": "ALEXANDRA",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beacon Villa Alf Operating LLC
• Brittany Jade Beauchamp, APRN
• Ellen Berkowitz, MD
• Rachel Marie Bixler, M.D.
• Board of County Commissioners Gulf County (Gulf County EMS)
• Brittny Brown, PHELCOTOMIST
• Tandra F Burns, BA
• William Rex Buzzett
• Candi Calderon, CPNP
• Efren Carbonell, M.D.

• Behavior Technician in Port St Joe, FL
• Providers in Port St Joe, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.