MEDICARE: BUILDING BLOCKS ABA LLC

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	:	1457231029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUILDING BLOCKS ABA LLC

Provider Business Mailing Address
First Line	:	1707 CONSERVATION TRL UNIT 206
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-5080
Country	:	US
Telephone Number	:	850-797-0805
Fax Number	:

Provider Business Practice Location Address
First Line	:	1707 CONSERVATION TRL UNIT 206
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-5080
Country	:	US
Telephone Number	:	850-797-0805
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JORDAN GARICK
Credential	:	BCBA
Telephone Number	:	850-797-0805

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	01/24/2026

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