Keesha Charles, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

21184814 Issued in FL

Practice address

537 Deltona Blvd Ste 101
Deltona, FL 32725-8017

Phone

(904) 878-8683

NPI assigned

Oct 1, 2021

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1811669385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 LIMELIGHT CIR STE 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328397379",
            "telephone_number": "904-878-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 DELTONA BLVD STE 101",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327258017",
            "telephone_number": "904-878-8683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 S Ridgewood Ave Ste 32",
            "address_purpose": "LOCATION",
            "city": "South Daytona",
            "state": "FL",
            "postal_code": "321193073",
            "country_code": "US",
            "telephone_number": "904-878-8683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "KEESHA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "21184814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Deltona, FL
• Providers in Deltona, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.