Christine Alexandra Forde

Individual provider Active NPI Behavior Analyst · Deerfield BCH, FL

NPI 1992218002 · NPPES record last updated Aug 22, 2022

Key facts

NPI
1992218002
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-22-61078 (FL)
Practice address
500 Fairway Dr Ste 102
Deerfield BCH, FL 33441-1817
Phone
(888) 880-9270
NPI assigned
Nov 10, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Mod Behavior ABA, LLC Behavior Analyst Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Analyst 103K00000X 1-22-61078 FL Yes

Addresses

Primary practice location

500 Fairway Dr Ste 102
Deerfield BCH, FL 33441-1817

Mailing address

500 Fairway Dr Ste 102
Deerfield BCH, FL 33441-1817

Other providers in Deerfield BCH, FL

All providers in Deerfield BCH, FL · Behavior Analyst in Florida

Sources for this page

Verify at the official NPI Registry.