Individual provider Active NPI

Mindy Jeanne Cassano, M.S., BCBA, LBA

  • Behavior Analyst
  • Islandia, NY
National Provider Identifier
1053700864
Registry record updated Jul 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
71000611 Issued in NY
Practice address
1737 Veterans Memorial Hwy
Islandia, NY 11749-1529
Phone
(631) 872-6435
NPI assigned
Jan 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2017

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 71000611 NY Primary

Addresses

Primary practice location

1737 Veterans Memorial Hwy
Islandia, NY 11749-1529

Mailing address

27 Ruth PL
North Babylon, NY 11703-4912

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 Science

State licenses

LicenseStateTypeSpecialty
71000611NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1053700864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 RUTH PL",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117034912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 VETERANS MEMORIAL HWY",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117491529",
            "telephone_number": "631-872-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSANO",
        "first_name": "MINDY",
        "middle_name": "JEANNE",
        "credential": "M.S., BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-16",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "71000611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islandia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2017; 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.