TIFFANY WISHAM
NPI 1003561622
Behavior Technician in Jacksonville, FL

Active since February 14, 2022
12724 GRAN BAY PKWY W STE 410, JACKSONVILLE, FL 32258(855) 832-6727 Get Directions Write a Review

NPPES record last updated: September 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tiffany Wisham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIFFANY WISHAM (NPI 1003561622) is an individual behavior technician in Jacksonville, Florida and active in the NPI registry since February 2022.

NPPES Registry Identity

NPI1003561622
Entity TypeIndividualFemale
Primary Taxonomy106S00000X
Provider Legal NameTIFFANY WISHAM
Location Address12724 GRAN BAY PKWY W STE 410Jacksonville, FL 32258-9486
Mailing Address300 International Pkwy Ste 200Lake Mary, FL 32746-5028 · (866) 610-0580
Sole ProprietorNo
Enumeration DateFebruary 14, 2022
Last NPPES UpdateSeptember 28, 2025
NPPES CertifiedSeptember 28, 2025
NPI 1003561622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyBehavior TechnicianBehavioral Health & Social Service Providers
Taxonomy Code106S00000X
Definition
The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.
12724 GRAN BAY PKWY W STE 410, Jacksonville, FL 32258

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Social Worker (Clinical)
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Nurse Practitioner (Psychiatric/Mental Health)
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Analyst
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiffany Wisham's NPI number?

The NPI number for Tiffany Wisham is 1003561622. It was assigned to this individual provider in the NPPES registry on February 14, 2022.

Where is Tiffany Wisham located?

Tiffany Wisham practices at 12724 Gran Bay Pkwy W Ste 410, Jacksonville, FL 32258. The listed phone number is (855) 832-6727.

What is Tiffany Wisham's specialty?

The primary specialty registered for this NPI is Behavior Technician with taxonomy code 106S00000X.

When was this NPI record last updated?

The NPPES record for Tiffany Wisham was last updated on September 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.