Active NPI
Mikaela C Benway
- Behavior Technician
- Palm City, FL
National Provider Identifier
1790486231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1765 SW Captains PL
Palm City, FL 34990-1747 - Phone
- (772) 266-8727
- Fax
- (772) 494-7093
- NPI assigned
- Mar 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1765 SW Captains PL
Palm City, FL 34990-1747
Mailing address
2555 Pga Blvd
Palm Beach Gardens, FL 33410-2957
Phone (804) 385-3577
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simplyaba, LLC | Multi-Specialty | Current | Accepting new patients |
| My Favorite Therapists, LLC | Multi-Specialty | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1790486231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2555 PGA BLVD",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334102957",
"telephone_number": "804-385-3577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1765 SW CAPTAINS PL",
"city": "PALM CITY",
"state": "FL",
"postal_code": "349901747",
"telephone_number": "772-266-8727",
"fax_number": "772-494-7093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENWAY",
"first_name": "MIKAELA",
"middle_name": "C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-13",
"last_updated": "2023-03-13",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.