Stephanie Lynn Tackett

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

19503 S West Villages Pkwy Ste 11
Venice, FL 34293-5108

Phone

(813) 720-7529

NPI assigned

Aug 7, 2017

Last updated

Feb 21, 2025By the provider in NPPES

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

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1962927301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19503 S WEST VILLAGES PKWY STE 11",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935108",
            "telephone_number": "813-720-7529",
            "fax_number": "941-681-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19503 S WEST VILLAGES PKWY STE 11",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935108",
            "telephone_number": "813-720-7529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18245 Paulson Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339541019",
            "country_code": "US",
            "telephone_number": "813-528-7048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David Khain Vay Taing, M.D., D.C., C.A.Q.SM
• James Patrick Takara, MD
• James Edward Tallman, RPH
• Hallie Rebecca Talov, LCSW
• Helberts C. Tambley, PT

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

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