Addison Gilligan

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-24-360152 Issued in FL

Practice address

13424 Fort King Rd
Dade City, FL 33525-5214

Phone

(352) 437-3559

NPI assigned

Jul 10, 2024

Last updated

Jul 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Luminescence Therapy LLC

  • Behavior Analyst
  • Dade City, FL
  • NPI 1700508041
  NPD

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1801633540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 ATAMI CT",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446845",
            "telephone_number": "352-727-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13424 FORT KING RD",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255214",
            "telephone_number": "352-437-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIGAN",
        "first_name": "ADDISON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-360152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Giardino, APRN
• Susan J Gibbs, ARNP
• Gil Fernandez, LMHC PA (Gil Fernandez Counseling & Assessments)
• Emily Gilbert
• Angelina Giles
• Krysantine Gonzales, PT
• Jennifer Gonzalez Chavez
• Anabel Gonzalez
• Dinah Deal Grant, RN
• Tanisha Grant, PMHNP-C

• Behavior Technician in Dade City, FL
• Providers in Dade City, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.