KELY-MARIE JACKSON (NPI# 1356971360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356971360 |
| Entity Type | Individual |
| Full Name | KELY-MARIE JACKSON |
| Practice Address |
9141 Cypress Green Dr Ste 2 Jacksonville FL 32256-2006 |
| Mailing Address |
1516 12th Ave N Jax Bch FL 32250-2834 |
| Practice Telephone | 9046471849 |
| Mailing Telephone | 9049822814 |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | FL | Behavioral Health & Social Service Providers |
| Street Address |
9141 CYPRESS GREEN DR STE 2 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982005716 | Darbrisha Bradley | Behavioral Analyst | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256-2006 | 2014-09-11 |
| 1609493246 | Madison Przydzial | Behavioral Analyst | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256-2006 | 2020-06-30 |
| 1003449349 | Amanda Meshaw | Behavior Technician | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256-2006 | 2020-02-14 |
| 1407408594 | Brooks Bernstein | Behavior Technician | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256-2006 | 2019-07-10 |
| 1629638002 | Therese Linton | Behavior Technician | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256-2006 | 2019-06-18 |
| 1407414923 | Dorothy Estep | Behavior Technician | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256-2006 | 2019-05-30 |
| 1013574110 | Starr S Little | Behavior Technician | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256-2006 | 2019-05-23 |
| 1841853538 | Amani Omar Marar | Behavior Technician | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256-2006 | 2019-04-17 |
| 1942774302 | Breanna Leigh Joy Strevig | Behavior Technician | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256 | 2019-01-17 |
| 1518463140 | Pathway Healthcare Florida, LLC | Family Medicine | 9141 Cypress Green Dr Ste 2, Jacksonville, FL 32256-2006 | 2018-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
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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.