Individual provider Active NPI

Micah Garvin, BCBA

  • Behavior Analyst
  • Louisville, KY
National Provider Identifier
1891375879
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-26-90581 Issued in FL
Practice address
1230 Liberty Bank LN Ste 230
Louisville, KY 40222-5756
Phone
(855) 444-5664
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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 1-26-90581 FL Primary

Addresses

Primary practice location

1230 Liberty Bank LN Ste 230
Louisville, KY 40222-5756

Mailing address

102 Kingswood CT
Sanford, FL 32773-4704
Phone (407) 690-6140

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

OrganizationSpecialtyStatusNew patients
Licini Inc Behavior Analyst CurrentSince Mar 19, 2023 Accepting new patients

Locations

782 Foxridge Center Dr
Orange Park, FL 32065
Phone (904) 579-3280

Organizations & group practices 1

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1891375879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 KINGSWOOD CT",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327734704",
            "telephone_number": "407-690-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 LIBERTY BANK LN STE 230",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225756",
            "telephone_number": "855-444-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARVIN",
        "first_name": "MICAH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-26-90581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.