Individual provider Active NPI

Christina Lee Tucker, MS, BCBA

  • Behavior Analyst
  • Port Orange, FL
National Provider Identifier
1720222730
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-12857 Issued in FL
Practice address
4647 Clyde Morris Blvd Unit 501
Port Orange, FL 32129-3001
Phone
(386) 767-3752
Fax
(386) 767-4319
NPI assigned
Apr 22, 2009
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-12857 FL Primary

Addresses

Primary practice location

4647 Clyde Morris Blvd Unit 501
Port Orange, FL 32129-3001

Mailing address

4647 Clyde Morris Blvd Unit 501
Port Orange, FL 32129-3001
Phone (386) 767-3752

Other names 1

  • Christina Williams 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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Chase Therapies Inc. Behavior Analyst Past Accepting new patients
Strategies, Inc. Behavior Analysis & Therapeutic Services Behavior Analyst PastSince Jul 1, 2021 Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1720222730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4647 CLYDE MORRIS BLVD UNIT 501",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321293001",
            "telephone_number": "386-767-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 CLYDE MORRIS BLVD UNIT 501",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321293001",
            "telephone_number": "386-767-3752",
            "fax_number": "386-767-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CHRISTINA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "MS, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-13-12857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "WILLIAMS",
            "credential": "MS, BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.