Individual provider Active NPI

Tonya Marie Woods, MS

  • Behavior Analyst
  • St Augustine, FL
National Provider Identifier
1780030544
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BH002795 Issued in PA
Practice address
762 Scrub Jay Dr
St Augustine, FL 32092-1729
Phone
(904) 446-8428
Fax
(844) 770-0422
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 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 BH002795 PA Primary

Addresses

Primary practice location

762 Scrub Jay Dr
St Augustine, FL 32092-1729

Mailing address

2220 County Road 210 W Ste 108-313
Jacksonville, FL 32259-4058
Phone (904) 446-8428

Other practice location 1

1347 Hausman Rd
Allentown, PA 18104-9063
Phone (610) 573-2512

Other identifiers 1

IdentifierTypeStateIssuer
1-14-17431OtherBEHAVIOR ANALYSIS CERTIFICATION BOARD

Other names 1

  • Tonya Marie Marsteller 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

State licenses

LicenseStateTypeSpecialty
BH002795PAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar and Stream Counseling LLC CurrentSince Jan 24, 2021 Accepting new patients
Oak Tree ABA Therapy LLC CurrentSince Jan 24, 2021 Accepting new patients

Locations

2220 County Road 210 W
Ste 108313
Jacksonville, FL 32259
Phone (904) 446-8428

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": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1780030544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 COUNTY ROAD 210 W STE 108-313",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594058",
            "telephone_number": "904-446-8428",
            "fax_number": "844-770-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 SCRUB JAY DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320921729",
            "telephone_number": "904-446-8428",
            "fax_number": "844-770-0422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1347 Hausman Rd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181049063",
            "country_code": "US",
            "telephone_number": "610-573-2512",
            "fax_number": "610-573-2598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODS",
        "first_name": "TONYA",
        "middle_name": "MARIE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH002795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYSIS CERTIFICATION BOARD",
            "identifier": "1-14-17431",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONYA",
            "last_name": "MARSTELLER",
            "middle_name": "MARIE",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.