MRS. EBONY RENE WILLIS (NPI# 1720598311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720598311 |
| Entity Type | Individual |
| Full Name | MRS. EBONY RENE WILLIS |
| Credential | RBT |
| Practice Address |
2609 Flamingo Dr Columbia SC 29209-4513 |
| Practice Telephone | 8034974303 |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2017-10-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487205787 | Ebony De-shonia Willis | Psychologist | 1777 Axtell Dr Ste 107, Troy, MI 48084-4400 | 2019-09-27 |
| Street Address |
2609 FLAMINGO DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29209-4513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992293013 | Pertile Group LLC | Family Medicine | 26 Foot Point Rd, Columbia, SC 29209 | 2018-04-24 |
| 1083156061 | Derek Clark | Physical Therapist | 6349 Garners Ferry Rd, Columbia, SC 29209 | 2016-11-08 |
| 1922450345 | Heather Alexander | Social Worker | 6439 Garners-ferry Road, Suite 122, Wjb Dorn Va, Columbia, SC 29209 | 2016-07-09 |
| 1265888325 | Daphne Elaine Allen | Counselor | 1850 Pinview Dr, Columbia, SC 29209 | 2016-05-09 |
| 1659757649 | Marc Edmundson | Pharmacist | 500 Gills Creek Pkwy #810, Columbia, SC 29209 | 2015-08-03 |
| 1477949113 | Winter Years Home Health Care Agency, LLC | Home Health | 1101 1st Street, P, Columbia, SC 29209 | 2015-04-09 |
| 1285045773 | Alireza Adhami | Pharmacist | 7235 Garners Ferry Rd, Columbia, SC 29209 | 2014-05-19 |
| 1790039212 | Immediate Dental Group Columbia | Dentist | 1118 Greenlawn Drive, Columbia, SC 29209 | 2012-11-06 |
| 1275896284 | Tariq Horani | Internal Medicine | 6349 Garners Ferry Road, Int Med -, Columbia, SC 29209 | 2012-06-25 |
| 1902165467 | Medcare Urgent Care Center Garners Ferry, LLC | Clinic/Center | 7418 Garners Ferry Road, Columbia, SC 29209 | 2012-05-03 |
| Find all providers in zip 29209 | ||||
| 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 |
|---|---|---|---|---|
| 1124628821 | Shadiat Ogunsakin | Behavior Technician | 7060 Samuel Morse Dr., Ste 100, Columbia, MD 21046 | 2020-10-30 |
| 1104423029 | Khashema Boyer | Behavior Technician | 8950 Rte 108 Ste 123, Columbia, MD 21045-2146 | 2020-10-04 |
| 1689281974 | Shalexis Wilson | Behavior Technician | 10360 Swift Stream Pl Apt 412, Columbia, MD 21044-4943 | 2020-09-30 |
| 1144834219 | Hanna Doherty | Behavior Technician | 350 Taylor St Unit G, Columbia, SC 29201-2292 | 2020-09-04 |
| 1659983211 | Courtney Danielle Henderson | Behavior Technician | 10015 Old Columbia Road, Suite B215, Columbia, MD 21046 | 2020-08-17 |
| 1346859048 | Jessica Jane Russell | Behavior Technician | 1107 Carrie Bolin Dr, Columbia, KY 42728-1034 | 2020-07-28 |
| 1235748914 | Heather Marie Merchant | Behavior Technician | 5682 Stevens Forest Rd Apt 44, Columbia, MD 21045-3312 | 2020-07-28 |
| 1720606155 | Jennifer Michelle Cundiff | Behavior Technician | 309 Hurt St Apt 202, Columbia, KY 42728-2303 | 2020-07-13 |
| 1497374136 | Keenan Eldridge | Behavior Technician | 8950 Md-108, Suite 100, Columbia, MD 21045 | 2020-04-13 |
| 1275166761 | Isis Marie Pearson | Behavior Technician | 4611 Hardscrabble Rd, #239, Columbia, SC 29229 | 2020-02-13 |
| Find all providers in COLUMBIA | ||||
Please comment or provide details below to improve the information on MRS. EBONY RENE WILLIS.
| 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.