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Jalissa Lake

Behavior Analyst β€’ Tampa, FL

Active NPI 1962991588 Individual Practitioner Female Practitioner
Practice location in NPPES

4940 Northdale Blvd
Tampa, FL 336241075

Call 8134858444 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4940 Northdale Blvd

Tampa, FL 336241075

Telephone 8134858444
Organization at the Same NPPES Address or Phone
Shaping Expectations Therapy Facility NPI 1407363641

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Tampa and Florida

665 active clinicians are listed under Behavior Analyst with a practice address in Tampa, FL (13,581 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Tampa

0% of these 665 clinicians have the CMS telehealth indicator.

0% of these 665 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-08-07
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

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.

Behavior Technician

NUCC Taxonomy Code: 106S00000X

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

12 Historical Events
πŸ“
Updated Business Mailing Address August 07, 2025

Registered at 4940 NORTHDALE BLVD, TAMPA, FL 336241075 (Tel: 8134858444)

πŸ“
Updated Practice Location October 23, 2022

Registered at 4940 NORTHDALE BLVD, TAMPA, FL 336241075 (Tel: 8134858444)

πŸ“
Updated Practice Location September 26, 2021

Registered at 9200 NW 39TH AVENUE, SUITE 130-1020, GAINESVILLE, FL 326067331 (Tel: 8558326727)

πŸ“
Updated Business Mailing Address September 26, 2021

Registered at 7108 SOUTH KANNER HWY,, STUART, FL 349977462 (Tel: 8666100580)

πŸ“
Updated Business Mailing Address May 30, 2019

Registered at 300 INTERNATIONAL PKWY, STE 200, LAKE MARY, FL 32746 (Tel: 8666100580)

πŸ“
Updated Practice Location October 08, 2018

Registered at 2437 SE 17TH STREET, UNIT 102, OCALA, FL 344719105 (Tel: 8666100580)

βœ…
NPI Profile Active May 09, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 09, 2018

Registered at 2437 SE 17TH ST, OCALA, FL 344719105 (Tel: 8666100580)

πŸ“
Business Mailing Address (Initial Record) May 09, 2018

Registered at 175 MIDDLE ST UNIT 1201, LAKE MARY, FL 327463625 (Tel: 8666100580)

πŸ‘€
Provider Name / Credentials (Initial Record) May 09, 2018

Recorded as JALISSA LAKE

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 09, 2018

Behavior Technician

🟒
Initial NPI Registration & Enumeration May 09, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1962991588
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 09, 2018
Last Update: August 07, 2025
Sole Proprietor: Yes

Mailing Address

4940 Northdale Blvd

Tampa, FL 336241075

Phone: 8134858444

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.