Lisiane Pooch

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

11240 Waples Mill Rd Ste 101
Fairfax, VA 22030-6078

Phone

(571) 639-9276

NPI assigned

Oct 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1043786130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 WAPLES MILL RD STE 202",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307407",
            "telephone_number": "571-639-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 WAPLES MILL RD STE 101",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306078",
            "telephone_number": "571-639-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOCH",
        "first_name": "LISIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Edward Polasko, PA-C
• Jane H. Pollner, MD
• Valerie A Pomper, MD
• David L Pontell, DPM
• Bradford S Pontz, M.D.
• Tahimina Popal, NP
• Shabana Popalzai
• Shari A Pope-Williams, LPC
• Alyssa Michelle Pope, MSW
• Michelle Lynn Pope, MSN, APRN, FNP-BC

• Behavior Analyst in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.