Active NPI
Colleen Leclair, BCBA
- Behavior Analyst
- Seminole, FL
National Provider Identifier
1013678689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 547506
- Practice address
- 12590 79TH Ave
Seminole, FL 33776-3627 - Phone
- (956) 357-2589
- NPI assigned
- Jan 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 547506 | FL | Primary |
Addresses
Primary practice location
12590 79TH Ave
Seminole, FL 33776-3627
Mailing address
12590 79TH Ave
Seminole, FL 33776-3627
Phone (956) 357-2589
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 547506 | FL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Above and Beyond Behavior Analysis Virginia | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Tampa, FL
- NPI 1316641756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1013678689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12590 79TH AVE",
"city": "SEMINOLE",
"state": "FL",
"postal_code": "337763627",
"telephone_number": "956-357-2589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12590 79TH AVE",
"city": "SEMINOLE",
"state": "FL",
"postal_code": "337763627",
"telephone_number": "956-357-2589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LECLAIR",
"first_name": "COLLEEN",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-06",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "547506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seminole, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.