MEDICARE: STEPHANIE ANN MERCIER COOKSEY BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1144552795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ANN MERCIER COOKSEY BCBA

Provider Business Mailing Address
First Line	:	522 9TH ST W STE 2
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34205-7700
Country	:	US
Telephone Number	:	844-854-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	522 9TH ST W STE 2
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34205-7700
Country	:	US
Telephone Number	:	844-854-7400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2010
Last Update Date	:	04/29/2026

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