Individual provider Active NPI

Colleen Cornwall

  • Behavior Analyst
  • Naples, FL
National Provider Identifier
1003117805
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
5860 Golden Gate Pkwy
Naples, FL 34116-7459
Phone
(239) 352-7600
NPI assigned
Nov 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

5860 Golden Gate Pkwy
Naples, FL 34116-7459

Mailing address

5860 Golden Gate Pkwy
Naples, FL 34116-7459
Phone (239) 352-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Applied Behavioral Learning Enterprises, Inc Behavior Analyst Current Accepting new patients

Locations

5860 Golden Gate Pkwy
Naples, FL 34116
Phone (239) 352-7600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1003117805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 GOLDEN GATE PKWY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341167459",
            "telephone_number": "239-352-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 GOLDEN GATE PKWY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341167459",
            "telephone_number": "239-352-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWALL",
        "first_name": "COLLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.