TRACY A SMITH (NPI# 1265031298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265031298 |
| Entity Type | Individual |
| Full Name | TRACY A SMITH |
| Credential | RBT |
| Practice Address |
4647 Clyde Morris Blvd Unit 501 Port Orange FL 32129-3001 |
| Mailing Address |
9 Red Birch Ln Palm Coast FL 32164-6666 |
| Practice Telephone | 3867673752 |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-20-137046 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681036 | Tracy Smith | In Home Supportive Care | 2400 Buffalo Gap Rd # 189, Abilene, TX 79605-6102 | 2020-08-25 |
| 1881236552 | Tracy Smith | Contractor | 1619 3rd Ave Se, Rochester, MN 55904-7945 | 2019-10-14 |
| 1619534013 | Tracy Erica Smith | Technician, Other | 1202 Glenview Dr, Mogadore, OH 44260-9581 | 2019-05-22 |
| 1346709011 | Tracy Cornelia Smith | Nurse Practitioner | 6104 Raleigh St Apt 1606, Orlando, FL 32835-2230 | 2019-03-13 |
| 1588135750 | Tracy Jo Smith | Voluntary or Charitable | 4259 N Williamston Rd, Williamston, MI 48895-9175 | 2018-12-16 |
| 1194222372 | Tracy Lynette Smith | Counselor | 55 Seargent Dr, Natchez, MS 39120-4782 | 2018-04-12 |
| 1740728070 | Tracy Smith | Social Worker | 8507 Ne 47th Street, Spencer, OK 73084 | 2017-02-07 |
| 1194273425 | Tracy Smith | Social Worker | 40 Daveitta Dr, Savannah, GA 31419-3155 | 2016-09-15 |
| 1265810410 | Tracy Dawn Smith | Counselor | 400 Bhrett Dr, Energy, IL 62933-3570 | 2015-05-08 |
| 1457789356 | Tracy L Smith | Behavioral Analyst | 10917 N Blackwelder Ave, Oklahoma City, OK 73120-7915 | 2013-10-31 |
| Street Address |
4647 CLYDE MORRIS BLVD UNIT 501 |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639593502 | Jeremiah Ross | Assistant Behavior Analyst | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2014-02-12 |
| 1902412224 | Esther Drumheller Hetzel | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2020-09-22 |
| 1588270532 | Kristi Susann Pace | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2020-09-16 |
| 1932727757 | Michaela Riane Cummo | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2020-07-08 |
| 1740805480 | Kayla Rogers | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2020-06-09 |
| 1134743909 | Chimsomaga Vivian Ozuzu | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2020-06-07 |
| 1154943124 | Brandie Nicole Scheu | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2020-05-13 |
| 1912553777 | Zalika A Freeman | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2019-08-16 |
| 1164076576 | Lakesha Jones | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2019-07-25 |
| 1881256444 | Andrea Williams | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2019-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548814536 | Shea Alexis Mclean-reshen | Behavior Technician | 3781 Grove View Ln, Port Orange, FL 32129-8602 | 2019-07-28 |
| 1538625231 | Liana Divoky Tomei | Behavior Technician | 11 Royal Palm Cir, Port Orange, FL 32127-5307 | 2019-02-18 |
| 1942772868 | Jared R Pagan | Behavior Technician | 4647 Clyde Morris Blvd, Port Orange, FL 32129-3000 | 2018-12-18 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1083214092 | Stephanie Valdes | Behavior Technician | 4647 Clyde Morris Blvd, Port Orange, FL 32129-3000 | 2020-10-28 |
| 1437756871 | Caitlin Anderson | Behavior Technician | 823 Dunlawton Ave, Port Orange, FL 32127-4220 | 2020-10-08 |
| 1225635717 | Kailey Mireles | Behavior Technician | 823 Dunlawton Ave, Port Orange, FL 32127-4220 | 2020-10-07 |
| 1790392017 | Suheir Aljundi | Behavior Technician | 823 Dunlawton Ave, Port Orange, FL 32127-4220 | 2020-09-30 |
| 1770199879 | Brandi Brooks | Behavior Technician | 823 Dunlawton Ave, Port Orange, FL 32127-4220 | 2020-09-23 |
| 1902412224 | Esther Drumheller Hetzel | Behavior Technician | 4647 Clyde Morris Blvd Unit 501, Port Orange, FL 32129-3001 | 2020-09-22 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.