=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174438550
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEHAVIORAL EXCELLENCE AND SKILL TRAINING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2026
-----------------------------------------------------
Last Update Date | 08/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 132 W INTERNATIONAL SPEEDWAY BLVD STE 81
-----------------------------------------------------
City | DAYTONA BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32114-4322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-456-4921
-----------------------------------------------------
Fax | 251-309-4480
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 48 PERGOLA PL
-----------------------------------------------------
City | ORMOND BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32174-1059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-327-7550
-----------------------------------------------------
Fax | 251-309-4480
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ BCBA
-----------------------------------------------------
Name | MACHELISE SIMONE GIBSON
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 863-327-7550
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------