Gina Marie Porcelli

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133003729 Issued in VA

Practice address

9833 Patriot Hwy
Fredericksburg, VA 22407-9422

Phone

(540) 847-1936

NPI assigned

Jul 2, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Skyward Behavioral Health, PLLC

  • Behavior Analyst
  • Glen Allen, VA
  • NPI 1437931383
  NPD (past)
• MPS Health Care

  • Counselor
  • Lakewood, CO
  • NPI 1962165480
  NPD (past)
• MPS Healthcare Inc

  • Behavior Analyst
  • Lakewood, CO
  • NPI 1023683596
  NPD (past)

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1063074896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10520 ABBERLY VILLAGE LN APT 123",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072728",
            "telephone_number": "540-604-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9833 PATRIOT HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079422",
            "telephone_number": "540-847-1936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7220 W Jefferson Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802352023",
            "country_code": "US",
            "telephone_number": "303-957-4067",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14367 Ashland Rd",
            "address_purpose": "LOCATION",
            "city": "Glen Allen",
            "state": "VA",
            "postal_code": "230591602",
            "country_code": "US",
            "telephone_number": "804-972-5272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8230 Leesburg Pike Ste 740",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221822641",
            "country_code": "US",
            "telephone_number": "877-504-4141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORCELLI",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133003729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fredericksburg",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "7220 W Jefferson Ave Ste 202",
            "city": "Lakewood",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802352023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laila Mackenzie Polk
• Traci Pomeroy, RBT
• Kaitlin Pond, P.A.
• Amy Charlene Pontarelli, RBT
• H L Pope Jr., DDS
• Dina P Porter, DDS
• Jason Max Porter, CRNA
• Katina Porter, MS
• Tammy L Porter
• Marie Michelle Porthouse, N.P.

• Behavior Analyst in Fredericksburg, VA
• Providers in Fredericksburg, 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 13, 2024; 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.