Individual provider Active NPI

Daniela E Van Dalen

  • Behavior Technician
  • Stuart, FL
National Provider Identifier
1770291965
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
22-240693 Issued in FL
Practice address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Phone
(855) 832-6727
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 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 22-240693 FL Primary

Addresses

Primary practice location

7108 S Kanner Hwy
Stuart, FL 34997-7462

Mailing address

11971 SW 119TH St
Miami, FL 33186-5113
Phone (786) 731-5645

Other practice location 1

10300 SW 72nd St Ste 114
Miami, FL 33173-3038
Phone (305) 508-5580

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
22-240693FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1770291965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11971 SW 119TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865113",
            "telephone_number": "786-731-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10300 SW 72nd St Ste 114",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331733038",
            "country_code": "US",
            "telephone_number": "305-508-5580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DALEN",
        "first_name": "DANIELA",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "22-240693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.