KISMA DICKERSON (NPI# 1609419605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609419605 |
| Entity Type | Individual |
| Full Name | KISMA DICKERSON |
| Practice Address |
11905 Bowman Dr Ste 507 Fredericksburg VA 22408-7344 |
| Practice Telephone | 5403959962 |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
11905 BOWMAN DR STE 507 |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22408-7344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104242627 | Elizabeth Brady | Behavioral Analyst | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2014-03-07 |
| 1316551807 | Tanika Boyette | Behavior Technician | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2020-09-02 |
| 1407470925 | Dominque Washington | Behavior Technician | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2020-06-01 |
| 1104440700 | Isabel Scholz | Behavior Technician | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2020-05-31 |
| 1841824042 | Nathan Willis | Behavior Technician | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2020-02-26 |
| 1700410396 | Shakia Williams | Behavior Technician | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2020-02-24 |
| 1013554757 | Pariss Samuels | Behavior Technician | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2019-12-02 |
| 1306488135 | Katie Gamache | Behavior Technician | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2019-10-14 |
| 1952942369 | Avery Kopp | Assistant Behavior Analyst | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2019-10-07 |
| 1073163747 | Virginia Cox | Behavior Technician | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2019-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285108340 | Embrace Foster Care, LLC | Foster Care Agency | 10705 Spotsylvania Avenue, Suite 101, Fredricksberg, VA 22408 | 2019-01-11 |
| 1730698689 | Raza N Syed | Driver | 12804 Willow Point Drive, Fredericksburg, VA 22408 | 2017-09-22 |
| 1184149122 | Eve Hope Pendletom | Driver | 2717 Francis Ct, Fredericksbrg, VA 22408 | 2017-08-10 |
| 1700316304 | Transcendent Truth Inc | Counselor | 2601 Wheatland Wood Drive, Fredericksburg, VA 22408 | 2017-06-15 |
| 1487047361 | Michele Neverdon | Counselor | 150 Olde Greenwich Dr Ste 211, Fredericksburg, VA 22408 | 2015-03-16 |
| 1073903688 | Shelby Jean Galloway | Radiology | 12709 Willow Pt. Dr., Fredericksburg, VA 22408 | 2015-02-03 |
| 1417355066 | Hanger Prosthetics & Orthotics Inc | Durable Medical Equipment & Medical Supplies | 4543 Empire Ct, Fredericksburg, VA 22408 | 2014-12-15 |
| 1154726123 | Md Wellness and Health Center | Internal Medicine | 10518 Spotsylvania Ave, Suite 102, Fredericksburg, VA 22408 | 2014-11-03 |
| 1023358595 | Joyce Catherine Corbin Moya | Social Worker | 19003 Main Street, Fredericksburg, VA 22408 | 2013-02-21 |
| 1992063234 | Gustavo A Elias | Radiology | 10401 Spotsylvania Ave Ste 203, Fredericksburg, VA 22408 | 2012-04-24 |
| Find all providers in zip 22408 | ||||
| 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 |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1376164434 | Angela Maija-liisa Penn | Behavior Technician | 11415 Lone Pine Ct, Fredericksburg, VA 22408-0482 | 2020-04-29 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1780236174 | Valerie Hart | Behavior Technician | 3542 Len Hart Ln, Fredericksburg, VA 22408-0411 | 2019-07-15 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1346758109 | Daria Ditzler | Behavior Technician | 10707 Spotsylvania Ave Ste 101, Fredericksburg, VA 22408-2682 | 2018-01-15 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| 1831604164 | Emily Masannat | Behavior Technician | 1411 Princess Anne Street, Fredericksburg, VA 22401 | 2017-12-08 |
| Find all providers in FREDERICKSBURG | ||||
| City | FREDERICKSBURG |
| Zip Code | 22408 |
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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.