Individual provider Active NPI

Tara Therese Raleigh

  • Behavior Technician
  • Tampa, FL
National Provider Identifier
1710786355
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
22-22222 Issued in FL
Practice address
210 S Macdill Ave
Tampa, FL 33609-3131
Phone
(813) 475-4665
NPI assigned
Mar 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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 22-22222 FL Primary

Addresses

Primary practice location

210 S Macdill Ave
Tampa, FL 33609-3131

Mailing address

14074 Trouville Dr
Tampa, FL 33624-6958
Phone (612) 695-9609

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
22-22222FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1710786355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14074 TROUVILLE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336246958",
            "telephone_number": "612-695-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S MACDILL AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093131",
            "telephone_number": "813-475-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALEIGH",
        "first_name": "TARA",
        "middle_name": "THERESE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "22-22222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; 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.