Sandra Clarke

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

4670 Lipscomb St NE Ste 10
Palm Bay, FL 32905-2927

Phone

(813) 906-6203

Fax

(813) 436-5623

NPI assigned

Jun 28, 2023

Sex

Female

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

Practice roles

Locations

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.

• Building Blocks Applied Behavioral Services Inc

  • Behavior Analyst
  • Palm Bay, FL
  • NPI 1558015388
  NPD

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1942987276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 LIPSCOMB ST NE STE 10",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052927",
            "telephone_number": "813-906-6203",
            "fax_number": "813-436-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 LIPSCOMB ST NE STE 10",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052927",
            "telephone_number": "813-906-6203",
            "fax_number": "813-436-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Circles of Care, Inc.
• Clara'S Angels
• Darius Clark
• Nanette Sebrena Clark
• Rachel Leah Clark, FNP-C
• Cecilia V Claxton
• Brenda K Clemens, NP
• Nikisha Nicole Clementin, M.ED. CCC-SLP
• Climb, Bcba Services, Inc
• Monica Lynn Cline, PSYD

• All providers in Palm Bay, FL
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.