MARY ELLEN MCCULLOUGH-LIST


Address: 3437 Miruelo Circle North, Jacksonville, FL 32217
Phone: 8558326727

MARY ELLEN MCCULLOUGH-LIST (NPI# 1336605005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336605005
Entity Type Individual
Full Name MARY ELLEN MCCULLOUGH-LIST
Credential RBT
Practice Address 3437 Miruelo Circle North
Jacksonville
FL 32217
Mailing Address 4575 Se Dixie Hwy
Stuart
FL 34997-6826
Practice Telephone 8558326727
Mailing Telephone 8558326727
Enumeration Date 2019-02-18
Last Update Date 2019-02-18
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 106S00000X Behavior Technician RBT-18--72833 Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
REGISTERED BEHAVIOR TECHNICIAN CERTIFICATION RBT-18-72833 01

Office Location

Street Address 3437 MIRUELO CIRCLE NORTH
City JACKSONVILLE
State FL
Zip Code 32217

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285131656 Priority One Home Care LLC In Home Supportive Care 7500 Powers Ave Apt 198, Jacksonville, FL 32217 2018-04-11
1407361272 Sharon Williams Home Health 8300 Plaza Gate Lane #1152, Jacksonville, FL 32217 2017-12-02
1548779929 Acumed Medical Ltd. Durable Medical Equipment & Medical Supplies 6653 Powers Avenue, Suite 134, Jacksonville, FL 32217 2017-09-28
1437685526 Ward Zeigler Behavior Technician 3437 Miruelo Cr. N., Jacksonville, FL 32217 2017-05-10
1538695754 Shilonda Peterson-jackson Technician, Other 3437 Miruelo Cr N, Jacksonville, FL 32217 2017-05-08
1114467834 Louis R. Lothman Counselor 3734 San Viscaya Dr., Jacksonville, FL 32217 2017-02-28
1023490141 A Gentle Touch Home Health Care LLC. Home Health 5991 Chester Avenue, Jacksonville, FL 32217 2015-06-25
1912320334 Christopher Marshall Fuller Developmental Therapist 5132 Edgeware Ct., Jacksonville, FL 32217 2014-01-22
1790040020 Maria R. Tapia Psychologist 7680 Smullian Trail West, Jacksonville, FL 32217 2012-07-12
1427314335 Antonio Loyola Massage Therapist 6550 Saint Augustine Rd Ste 304, Jacksonville, FL 32217 2012-04-04
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Taxonomy Information

Taxonomy Code 106S00000X
Grouping Behavioral Health & Social Service Providers
Classification Behavior Technician

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215544424 Brianna Rene Lavoie Behavior Technician 113g N Marine Blvd, Jacksonville, NC 28540-6508 2020-09-30
1013524925 Renee Cherie Titus Behavior Technician Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 2020-09-24
1558977330 Samantha Jo Gilmore Behavior Technician 2893 Post St Apt 4, Jacksonville, FL 32205-7447 2020-09-17
1639784135 Rhianna Fiona Valencia Behavior Technician 7718 Tunica Ct, Jacksonville, FL 32244-8169 2020-09-11
1710590302 Olivia Link Behavior Technician 2525 Dunn Ave Ste 2, Jacksonville, FL 32218-4680 2020-08-25
1821600768 Emily Mary Ross Behavior Technician 2869 Post St, Jacksonville, FL 32205-7456 2020-08-21
1639789290 April Elaine Crews Behavior Technician 9000 Southside Blvd, Jacksonville, FL 32256-0793 2020-08-07
1225656937 Roxana Maldonado Behavior Technician 2425 Dunn Ave # Sre2, Jacksonville, FL 32218-4603 2020-07-09
1023639747 Maaria Chehab Behavior Technician 7668 Saw Timber Ln, Jacksonville, FL 32256-2354 2020-05-05
1255966024 Okeya Johnson Behavior Technician 7960 103rd St Apt 1205, Jacksonville, FL 32210-6659 2020-03-11
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Competitor

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City JACKSONVILLE
Zip Code 32217

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Dataset Information

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.

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