Mia Green

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-68448 Issued in FL

Practice address

4611 SE 100TH PL
Belleview, FL 34420-3013

Phone

(352) 559-2539

NPI assigned

Aug 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifespan Behavior Services LLC

  • Early Intervention Provider Agency
  • Belleview, FL
  • NPI 1487102323
  NPD

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1780164046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 SE 100TH PL",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344203013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 SE 100TH PL",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344203013",
            "telephone_number": "352-559-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-23-68448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• God Answers Prayers-Emmanuel Inc
• God Answers Prayers, LLC
• Quadarious Gordon
• Grace and Harmony
• Sabrina Kelli Graham, ARNP
• Brandon Aaron Greis
• Growing Minds Therapy
• Danny Osniel Guerrero
• Margie Haines
• Gianna Hall

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.