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JALISSA LAKE
NPI 1962991588
Behavior Analyst in Tampa, FL

Active since May 09, 2018
4940 NORTHDALE BLVD, TAMPA, FL 33624(813) 485-8444 Get Directions Write a Review

NPPES record last updated: August 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 7, 2025, Oct 23, 2022, Sep 26, 2021 and 3 more (6 updates tracked since 2018).

About Jalissa Lake NPPES

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

JALISSA LAKE (NPI 1962991588) is an individual behavior analyst provider in Tampa, Florida and active in the NPI registry since May 2018.

NPPES Registry Identity

NPI1962991588
Entity TypeIndividualFemale
Primary Taxonomy103K00000X
Provider Legal NameJALISSA LAKE
Location Address4940 NORTHDALE BLVDTampa, FL 33624-1075
Mailing Address4940 Northdale BlvdTampa, FL 33624-1075 · (813) 485-8444
Phone(813) 485-8444
Sole ProprietorYes
Enumeration DateMay 9, 2018
Last NPPES UpdateAugust 7, 20256 updates tracked since enumeration
NPPES CertifiedAugust 7, 2025
✔ NPI 1962991588 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
Definition
A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
Also ListedBehavior TechnicianTaxonomy 106S00000X
4940 NORTHDALE BLVD, Tampa, FL 33624
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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.

TYLER SYDNEY HUNT
Behavior Technician
4940 NORTHDALE BLVD
TAMPA, FL 33624
Hillsborough County (813) 485-8444
SAMANTHA CUICAR
Behavior Technician
4940 NORTHDALE BLVD
TAMPA, FL 33624
Hillsborough County (813) 485-8444
JAVAN EMELIO YOUNG II
Behavior Technician
4940 NORTHDALE BLVD
TAMPA, FL 33624
Hillsborough County (813) 485-8444
JESSIE RENAUD
Behavior Analyst
4940 NORTHDALE BLVD
TAMPA, FL 33624
Hillsborough County (813) 485-8444
ORISNELDYS BERMUDEZ GUTIERREZ
Behavior Technician
4940 NORTHDALE BLVD
TAMPA, FL 33624
Hillsborough County (813) 485-8444
ALIVIA CAMPBELL MS
Behavior Analyst
4940 NORTHDALE BLVD
TAMPA, FL 33624
Hillsborough County (813) 485-8444
REBEKAH WALTERS
Assistant Behavior Analyst
4940 NORTHDALE BLVD
TAMPA, FL 33624
Hillsborough County (813) 485-8444
FADY W FAHIM
Behavior Technician
4940 NORTHDALE BLVD
TAMPA, FL 33624
Hillsborough County (813) 485-8444

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 Jalissa Lake's NPI number?

The NPI number for Jalissa Lake is 1962991588. It was assigned to this individual provider in the NPPES registry on May 9, 2018.

Where is Jalissa Lake located?

Jalissa Lake practices at 4940 Northdale Blvd, Tampa, FL 33624. The listed phone number is (813) 485-8444.

What is Jalissa Lake's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

When was this NPI record last updated?

The NPPES record for Jalissa Lake was last updated on August 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.