Individual provider Active NPI

Andrew Nicholas Thornburgh, MA, BCBA, LBA, RBA

  • Behavior Analyst
  • Lakeland, FL
National Provider Identifier
1043605165
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
61660534 Issued in WA
Practice address
600 Lake Hollingsworth Dr
Lakeland, FL 33803-2364
Phone
(253) 651-9602
NPI assigned
Apr 6, 2015
Last updated
May 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2026

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 61660534 WA Primary

Addresses

Primary practice location

600 Lake Hollingsworth Dr
Lakeland, FL 33803-2364

Mailing address

1409 W River CT
Valrico, FL 33596-7858
Phone (253) 651-9602

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
61660534WAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1043605165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 W RIVER CT",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335967858",
            "telephone_number": "253-651-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 LAKE HOLLINGSWORTH DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338032364",
            "telephone_number": "253-651-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNBURGH",
        "first_name": "ANDREW",
        "middle_name": "NICHOLAS",
        "credential": "MA, BCBA, LBA, RBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "61660534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.