Individual provider Active NPI

Johanna Eliacin

  • Behavior Analyst
  • Tampa, FL
National Provider Identifier
1841825528
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-25-79930 Issued in FL
Practice address
8001 Beaty Grove Dr
Tampa, FL 33626-1602
Phone
(813) 926-5454
NPI assigned
Mar 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-25-79930 FL Primary

Addresses

Primary practice location

8001 Beaty Grove Dr
Tampa, FL 33626-1602

Mailing address

8309 Broken Willow LN
Port Richey, FL 34668-6812
Phone (727) 481-0080

Other practice location 1

9525 Hudson Ave
Hudson, FL 34667-4402
Phone (727) 544-4700

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

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1841825528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 BROKEN WILLOW LN",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346686812",
            "telephone_number": "727-481-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 BEATY GROVE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261602",
            "telephone_number": "813-926-5454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9525 Hudson Ave",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "FL",
            "postal_code": "346674402",
            "country_code": "US",
            "telephone_number": "727-544-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELIACIN",
        "first_name": "JOHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-25-79930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.