Healthcare Provider Details

I. General information

NPI: 1861154221
Provider Name (Legal Business Name): SADE NACARDIA JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 FAIRVIEW RD STE 200
CHARLOTTE NC
28210-3297
US

IV. Provider business mailing address

5400 S UNIVERSITY DR STE 502
DAVIE FL
33328-5313
US

V. Phone/Fax

Practice location:
  • Phone: 980-317-8260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-69737
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: