Individual provider Active NPI

Michaela De-Ann Pansey, RBT

  • Behavior Technician
  • Lakeland, FL
National Provider Identifier
1710623228
Registry record updated May 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB766129 Issued in FL
Practice address
454 W Pipkin Rd
Lakeland, FL 33813-2545
Phone
(863) 619-2809
NPI assigned
May 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X BACB766129 FL Primary

Addresses

Primary practice location

454 W Pipkin Rd
Lakeland, FL 33813-2545

Mailing address

454 W Pipkin Rd
Lakeland, FL 33813-2545

Other practice location 1

145 E Edgewood Dr
Lakeland, FL 33803-4014
Phone (863) 619-2809

Other names 1

  • Michaela De-Ann Patterson Former name

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
BACB766129FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Applied Behavioral Learning Experiences, Inc CurrentSince Sep 1, 2019 Accepting new patients
Applied Behavioral Learning Experiences, Inc. Past Accepting new patients

Locations

454 W Pipkin Rd
Lakeland, FL 33813

145 E Edgewood Dr
Lakeland, FL 33803
Phone (863) 272-5297

Organizations & group practices 2

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": "1651968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651968000000",
    "number": "1710623228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 W PIPKIN RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 W PIPKIN RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132545",
            "telephone_number": "863-619-2809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 E Edgewood Dr",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338034014",
            "country_code": "US",
            "telephone_number": "863-619-2809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANSEY",
        "first_name": "MICHAELA",
        "middle_name": "DE-ANN",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-08",
        "last_updated": "2022-05-08",
        "certification_date": "2022-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "BACB766129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAELA",
            "last_name": "PATTERSON",
            "middle_name": "DE-ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2022; 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.