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NPI Code Detail

MEDICARE: ERIKA JOY EVERLY BCBA, LBA, LBS

MEDICARE: ERIKA JOY EVERLY BCBA, LBA, LBS
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
1106S00000XBehavior Technician32098199PA
2103K00000XBehavior Analyst1-20-46807

General Provider Information

NPI Number : 1902386717
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIKA JOY EVERLY BCBA, LBA, LBS
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 170 MEETING ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29401-3153
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2018
Last Update Date : 12/12/2022

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