Individual provider Active NPI

Melinda Vancleaf, MSED

  • Behavior Analyst
  • Staten Island, NY
National Provider Identifier
1043447634
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1697599 Issued in NY
Practice address
1911 Richmond Ave
Staten Island, NY 10314-3913
Phone
(718) 972-0880
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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 1697599 NY Primary

Addresses

Primary practice location

1911 Richmond Ave
Staten Island, NY 10314-3913

Mailing address

177 Raymond PL
Staten Island, NY 10310-2635
Phone (718) 816-4332

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

LicenseStateTypeSpecialty
1697599NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1043447634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 RAYMOND PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102635",
            "telephone_number": "718-816-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143913",
            "telephone_number": "718-972-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCLEAF",
        "first_name": "MELINDA",
        "credential": "MSED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1697599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.