Active NPI
Denise Bartizal Malone, PSYD, BCBA
- Behavior Analyst
- Petersburg, VA
National Provider Identifier
1033340591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11000078
- Practice address
- 19423 Indian Rd
Petersburg, VA 23805-8819 - Phone
- (540) 761-6306
- NPI assigned
- Aug 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11000078 | MI | Primary |
| Psychologist | 103T00000X | 0810000359 | VA |
Addresses
Primary practice location
19423 Indian Rd
Petersburg, VA 23805-8819
Mailing address
19423 Indian Rd
Petersburg, VA 23805-8819
Phone (540) 761-6306
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 |
|---|---|---|---|
| 11000078 | MI | MD | Behavioral Analyst |
| 0810000359 | VA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249084800000",
"number": "1033340591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19423 INDIAN RD",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238058819",
"telephone_number": "540-761-6306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19423 INDIAN RD",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238058819",
"telephone_number": "540-761-6306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALONE",
"first_name": "DENISE",
"middle_name": "BARTIZAL",
"name_prefix": "Dr.",
"credential": "PSYD, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-01",
"last_updated": "2009-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "11000078",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VA",
"license": "0810000359",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petersburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.