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NPI Code Detail

MEDICARE: KRISTIN BLAKE CARMICHAEL M.A.

MEDICARE: KRISTIN BLAKE CARMICHAEL M.A.
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
1103K00000XBehavior Analyst1-24-71430TN
2106S00000XBehavior TechnicianRBT-21-160052TN
3103K00000XBehavior Analyst1485TN
4171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-24-71430OTHERTNBACB
2RBT-21-160052OTHERTNBACB

General Provider Information

NPI Number : 1700109667
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN BLAKE CARMICHAEL M.A.
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-244-1818
Fax Number :
Provider Business Practice Location Address
First Line : 6312 KINGSTON PIKE STE B
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-4958
Country : US
Telephone Number : 844-854-1116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2010
Last Update Date : 04/09/2024

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