NPIMap

Organization Active NPI

Small Footsteps Licensed Behavior Analysis PC

  • PACE Provider Organization
  • Monroe, NY
National Provider Identifier
1750107546
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
SMALL FOOTSTEPS LICENSED BEHAVIOR ANALYSIS PC
Practice address
181 Pine Tree Rd
Monroe, NY 10950-3967
Phone
(646) 296-9221
NPI assigned
Nov 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Authorized official

Name
Widna TaverasNPI 1710249065
Title
Licensed Behavior
Phone
(646) 296-9221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

181 Pine Tree Rd
Monroe, NY 10950-3967

Mailing address

181 Pine Tree Rd
Monroe, NY 10950-3967
Phone (646) 296-9221

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1750107546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 PINE TREE RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109503967",
            "telephone_number": "646-296-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 PINE TREE RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109503967",
            "telephone_number": "646-296-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALL FOOTSTEPS LICENSED BEHAVIOR ANALYSIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "TAVERAS",
        "authorized_official_first_name": "WIDNA",
        "authorized_official_title_or_position": "LICENSED BEHAVIOR",
        "authorized_official_telephone_number": "646-296-9221"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.