NPIMap

Organization Active NPI

Equanimity Behavioral Services Co

  • Behavior Analyst
  • Miramar, FL
National Provider Identifier
1922527613
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
EQUANIMITY BEHAVIORAL SERVICES CO
Practice address
14359 Miramar Pkwy
Suite 504
Miramar, FL 33027
Phone
(650) 213-2283
NPI assigned
Sep 13, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Kelly Dayana Negron, D.H.SCI, ITDSNPI 1275918740
Title
President
Phone
(650) 213-2283

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Clinical Psychologist 103TC0700X NU
Clinical Child & Adolescent Psychologist 103TC2200X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Behavior Analyst 103K00000X NU Primary
Assistant Behavior Analyst 106E00000X NU
Behavior Technician 106S00000X NU

Addresses

Primary practice location

14359 Miramar Pkwy
Suite 504
Miramar, FL 33027

Mailing address

14359 Miramar Pkwy Ste 504
Miramar, FL 33027-4134
Phone (650) 213-2283

Other identifiers 1

IdentifierTypeStateIssuer
024772100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelly@equanimitytherapy.com

National Provider Directory

National Provider Directory
Tax ID family
Equanimity Behavioral Services Co2 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.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1922527613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14359 MIRAMAR PKWY STE 504",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274134",
            "telephone_number": "650-213-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14359 MIRAMAR PKWY",
            "address_2": "SUITE 504",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "33027",
            "telephone_number": "650-213-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUANIMITY BEHAVIORAL SERVICES CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "NEGRON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "DAYANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-213-2283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.H.SCI, ITDS"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024772100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly@equanimitytherapy.com",
            "affiliation": "N",
            "address_1": "14359 Miramar Pkwy",
            "address_2": "Suite 504",
            "city": "MIRAMAR",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.