NPIMap

Organization Active NPI

Easterseals Northeast Central Florida, Inc.

  • Behavior Analyst
  • New Smyrna Beach, FL
National Provider Identifier
1780435958
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.
Practice address
3804 Pioneer TRL
New Smyrna Beach, FL 32168-8784
Phone
(386) 255-4568
Fax
(386) 258-7677
NPI assigned
Mar 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Michele Wallens
Title
Accounting Manager
Phone
(386) 255-4568

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

3804 Pioneer TRL
New Smyrna Beach, FL 32168-8784

Mailing address

1219 Dunn Ave
Daytona Beach, FL 32114-2405
Phone (386) 255-4568

National Provider Directory

National Provider Directory
Tax ID family
Easter Seal Society25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1780435958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 DUNN AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142405",
            "telephone_number": "386-255-4568",
            "fax_number": "386-258-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 PIONEER TRL",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688784",
            "telephone_number": "386-255-4568",
            "fax_number": "386-258-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "WALLENS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "386-255-4568"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.