Provider Demographics
NPI:1174082044
Name:WINFIELD, IVY CAROLYN
Entity type:Individual
Prefix:
First Name:IVY
Middle Name:CAROLYN
Last Name:WINFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IVY
Other - Middle Name:CAROLYN
Other - Last Name:WOODRUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:1001 W NEW HAMPSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5701
Mailing Address - Country:US
Mailing Address - Phone:828-358-9992
Mailing Address - Fax:
Practice Address - Street 1:111 N ORANGE AVE STE 800
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2381
Practice Address - Country:US
Practice Address - Phone:443-540-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-21-12822106E00000X
RBT-17-43953106S00000X
FL1-25-79654103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-17-43953OtherREGISTERED BEHAVIOR TECHNICIAN
0-21-12822OtherBACB-BCABA
1-25-79654OtherBCBA