NPIMap

Organization Active NPI

Roots Behavior, LLC

  • Behavior Analyst
  • Fort Myers, FL
National Provider Identifier
1831855352
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
ROOTS BEHAVIOR, LLC
Practice address
12535 New Brittany Blvd Unit 2801
Fort Myers, FL 33907-3625
Phone
(239) 841-9035
Fax
(941) 866-2685
NPI assigned
Nov 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Authorized official

Name
Yashira N MartinezNPI 1093226128
Title
Bcba/Owner
Phone
(239) 841-9035

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106E00000X
Behavior TechnicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106S00000X

Addresses

Primary practice location

12535 New Brittany Blvd Unit 2801
Fort Myers, FL 33907-3625

Mailing address

1510 Oak Dr
Fort Myers, FL 33907-2816
Phone (239) 841-9035

National Provider Directory

National Provider Directory
Tax ID family
Roots Behavior LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

12535 New Brittany Blvd
Unit 2801
Fort Myers, FL 33907
Phone (239) 841-9035

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1831855352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 OAK DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072816",
            "telephone_number": "239-841-9035",
            "fax_number": "941-866-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12535 NEW BRITTANY BLVD UNIT 2801",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073625",
            "telephone_number": "239-841-9035",
            "fax_number": "941-866-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS BEHAVIOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "YASHIRA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "BCBA/OWNER",
        "authorized_official_telephone_number": "239-841-9035"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.