Space Coast Behavior Analysis LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SPACE COAST BEHAVIOR ANALYSIS LLC

Practice address

2226 Sarno Rd Ste 100
Melbourne, FL 32935-3087

Phone

(321) 313-4804

NPI assigned

Oct 19, 2022

Organization subpart

No

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

Authorized official

Name

Tina SmithNPI 1174761563

Title

Executive Director

Phone

(321) 313-4804

Specialties & licenses 1

Addresses

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tina M Smith, BCBA

  • Behavior Analyst
  • Melbourne, FL
  • NPI 1174761563
  NPD Authorized official
• Ariana Lenau

  • Behavior Technician
  • Melbourne, FL
  • NPI 1760160436
  NPD
• Jerrica Love

  • Behavior Technician
  • Melbourne, FL
  • NPI 1043073349
  NPD
• Genevieve Smith

  • Behavior Technician
  • Melbourne, FL
  • NPI 1770263253
  NPD
• Ciera Woods

  • Behavior Technician
  • Melbourne, FL
  • NPI 1265110910
  NPD

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1750007886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 LYTTON RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329349015",
            "telephone_number": "321-313-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 SARNO RD STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353087",
            "telephone_number": "321-313-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST BEHAVIOR ANALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-313-4804"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sovereign Healthcare of Atlantic Shores, LLC
• Trey Sowards, PA-C
• Tristan Soyka, RD
• Space Coast Advanced Practice Consultants LLC
• Space Coast Assisted Living LLC
• Space Coast Corporate Health Service P a
• Space Coast Discovery, Inc.
• Space Coast Ear Nose and Throat Associates
• Space Coast Health and Wellness LLC
• Space Coast Health Care Network

• Behavior Analyst in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.