Individual provider Active NPI

Destiny Jewell, RBT

  • Behavior Technician
  • Jeffersonville, IN
National Provider Identifier
1891590519
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-410785 Issued in IN
Practice address
2916 Peach Blossom Dr Ste 104
Jeffersonville, IN 47130-8380
Phone
(812) 202-6144
NPI assigned
Feb 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-25-410785 IN Primary

Addresses

Primary practice location

2916 Peach Blossom Dr Ste 104
Jeffersonville, IN 47130-8380

Mailing address

3006 Eastpoint Pkwy
Louisville, KY 40223-4185
Phone (502) 795-0773

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

State licenses

LicenseStateTypeSpecialty
RBT-25-410785INMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Adaptive Community Support Services Inc Behavior Technician PastSince Feb 23, 2025 Accepting new patients
Adaptive Community Support Services Inc PastSince Feb 23, 2025 Accepting new patients

Organizations & group practices 2

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": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1891590519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 EASTPOINT PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234185",
            "telephone_number": "502-795-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 PEACH BLOSSOM DR STE 104",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471308380",
            "telephone_number": "812-202-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "DESTINY",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-25-410785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.