Benjamin Disse

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-21-165805 Issued in FL

Practice address

4014 Highway 90
Pace, FL 32571-1918

Phone

(850) 723-6570

Fax

(850) 994-8443

NPI assigned

Apr 27, 2021

Last updated

Apr 27, 2021By the provider in NPPES

Sex

Male

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greater Pensacola Behavior Services Inc

  • Behavior Analyst
  • Milton, FL
  • NPI 1528465150

  Behavior Technician

  NPD
• Greater Pensacola Behavior Services Inc

  • Behavior Analyst
  • Pensacola, FL
  • NPI 1538732813
  NPD

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1912589953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 WILLIAMSON LN # 4122",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325712237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 HIGHWAY 90",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325711918",
            "telephone_number": "850-723-6570",
            "fax_number": "850-994-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISSE",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-21-165805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Renee Delacruz, PT, DPT
• Tara Denney, MS, OTR/L
• Jaqynne Diamond
• Melissa Maureen Diamond, PHARMD
• Patricia M Dillenback, MS LMFT
• Anna Lucille Dodson, PT
• Lauren Joelle Donahoo, LPN
• Heidi C Donovan, PHD
• Douglas Reynolds, O.D. Santa Rosa, P.a. (Gulf Coast Vision Center)
• Janice Mont Dsilva, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.