{
"Npi": {
"NPI": "1174884134",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "APPLIED BEHAVIOR APPROACHES OF TAMPA BAY INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1353 LOTUS PATH",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLEARWATER",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33756",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-241-0246",
"MailingAddressFaxNumber": "727-240-4720",
"FirstLinePracticeLocationAddress": "18946 NORTH DALE MABRY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LUTZ",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33548",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-241-0246",
"PracticeLocationAddressFaxNumber": "727-240-4720",
"EnumerationDate": "06/06/2012",
"LastUpdateDate": "08/05/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DEHAINAUT",
"AuthorizedOfficialFirstName": "ROBIN",
"AuthorizedOfficialMiddleName": "LANE",
"AuthorizedOfficialTitle": "OWNER; BOARD CERTIFIED BEHAVIOR ANA",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.A., BCBA",
"AuthorizedOfficialTelephoneNumber": "727-241-0246",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "1-09-5814",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}