MRS. THERESA PROVENZANO (NPI# 1568989416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568989416 |
| Entity Type | Individual |
| Full Name | MRS. THERESA PROVENZANO |
| Practice Address |
515 Palm Coast Pkwy Sw Palm Coast FL 32137-4739 |
| Mailing Address |
175 Middle St Unit 1201 Lake Mary FL 32746-3625 |
| Practice Telephone | 3869513044 |
| Mailing Telephone | 8666100580 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 106E00000X | Assistant Behavior Analyst | Behavioral Health & Social Service Providers | ||
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
515 PALM COAST PKWY SW |
| City | PALM COAST |
| State | FL |
| Zip Code | 32137-4739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962683714 | Dialysis Care Center of Palm Coast LLC | Clinic/Center | 515 Palm Coast Pkwy Sw, Units 2, 3, & 4, Palm Coast, FL 32137-5700 | 2007-11-21 |
| 1104380021 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 515 Palm Coast Pkwy Sw, Ste 2, 3, 4, Palm Coast, FL 32137-4739 | 2019-01-24 |
| 1083190631 | Rhonda D Calloway | Behavior Technician | 515 Palm Coast Pkwy Sw, Palm Coast, FL 32137-4739 | 2018-07-17 |
| 1033606116 | Shannon Ellis | Behavior Technician | 515 Palm Coast Pkwy Sw, Palm Coast, FL 32137-4739 | 2018-04-15 |
| 1760982615 | Alicia Cellini Desroches | Behavior Technician | 515 Palm Coast Pkwy Sw, Palm Coast, FL 32137-4739 | 2018-02-16 |
| 1306350681 | Janae' L. Wadley | Behavior Technician | 515 Palm Coast Pkwy Sw, Palm Coast, FL 32137-4739 | 2017-11-26 |
| 1376055855 | Diamon'e Godfrey | Behavior Technician | 515 Palm Coast Pkwy Sw, Palm Coast, FL 32137-4739 | 2017-10-24 |
| 1346750155 | Jaimi Nelson | Behavioral Analyst | 515 Palm Coast Pkwy Sw, Palm Coast, FL 32137-4739 | 2017-10-06 |
| 1497265599 | Kayla Marie Dillion | Behavior Technician | 515 Palm Coast Pkwy Sw, Palm Coast, FL 32137-4739 | 2017-10-04 |
| 1588173819 | Tamira Alston | Behavior Technician | 515 Palm Coast Pkwy Sw, Palm Coast, FL 32137-4739 | 2017-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922617505 | Palm Coast Alf Management LLC | Assisted Living Facility | 3830 Old Kings Road, Palm Coast, FL 32137 | 2020-07-29 |
| 1093324964 | Akilah Collins | Behavior Technician | 515 Palm Coast Pwky Sw, Suite 6, Palm Coast, FL 32137 | 2020-07-27 |
| 1750929477 | Jeanette Ann Stevens | Technician | 1 Lema Place, Palm Coast, FL 32137 | 2019-12-12 |
| 1649816919 | Patrick Meyer | Occupational Therapy Assistant | 9 Pine Cone Drive, Palm Coast, Palm Coast, FL 32137 | 2019-11-21 |
| 1689230385 | Coastal Care Medical Transport | Non-emergency Medical Transport (VAN) | #2b, 1 Hargrove Grde, Palm Coast, FL 32137 | 2019-05-17 |
| 1407357437 | Palm Coast Counseling, LLC | Counselor | 1 Hargrove Grade, Ste B-1, Palm Coast, FL 32137 | 2018-02-25 |
| 1679081459 | Lance J Langston | Behavior Technician | 2 Crosstie Ct, Palm Coast, FL 32137 | 2018-01-16 |
| 1407360712 | Hanna Mercedes Brown | Behavior Technician | 515 Palm Coast Pkwy, Suite 6/7, Palm Coast, FL 32137 | 2017-11-22 |
| 1760994511 | Sophia's Choice Hands That Help, LLC | Custodial Care Facility | 119 Bud Hollow Dr, Palm Coast, FL 32137 | 2017-11-02 |
| 1922543255 | Megan Katherine Dickerson | Physical Therapist | 250 Palm Coast Pkwy Ne Unit 209a, Palm Coast, FL 32137 | 2016-12-22 |
| Find all providers in zip 32137 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184162232 | Lindsay Michele Dibella | Behavioral Analyst | 19 President Ln, Palm Coast, FL 32164-7428 | 2017-02-09 |
| 1043757628 | Elizabeth Broomfield | Behavioral Analyst | 16 Warner Pl, Palm Coast, FL 32164-7660 | 2017-01-20 |
| 1972057578 | Gessica Joseph | Behavioral Analyst | 35 Prairie Ln, Palm Coast, FL 32164-4723 | 2016-08-11 |
| 1528417284 | Phillip King Jr. | Behavioral Analyst | 31 Lamour Ln, Palm Coast, FL 32137-9616 | 2016-06-03 |
| 1770949836 | Alicyn Dickey | Behavioral Analyst | 17 Unique Ct, Palm Coast, FL 32164-5764 | 2016-01-05 |
| 1972905339 | Christy Rose Reiter | Behavioral Analyst | 6 Cute Ct, Palm Coast, FL 32137-9001 | 2014-09-17 |
| 1457691636 | Lance Jordan Webber | Behavioral Analyst | 10 Louisiana Dr, Palm Coast, FL 32137-9705 | 2013-02-25 |
| 1184915621 | Harold Johanessen Jr. | Behavioral Analyst | 5 Ryker Ln, Palm Coast, FL 32164-3411 | 2011-05-02 |
| 1447558564 | Teresa Lago | Behavioral Analyst | 51 Fallen Oak Ln, Palm Coast, FL 32137-9132 | 2011-03-14 |
| 1417564998 | Emily F Tyskowski | Behavioral Analyst | 515 Palm Coast Pkwy Sw Ste 6, Palm Coast, FL 32137-5700 | 2020-09-28 |
| Find all providers in PALM COAST | ||||
| City | PALM COAST |
| Zip Code | 32137 |
Please comment or provide details below to improve the information on MRS. THERESA PROVENZANO.
| 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.