Active NPI
Katie Divelbiss, M.S., B.C.B.A.
- Behavior Analyst
- Alexandria, VA
National Provider Identifier
1063713808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-10-7769
- Practice address
- 5400 Shawnee Rd
Suite 208
Alexandria, VA 22312-2300 - Phone
- (703) 750-0633
- Fax
- (703) 750-0655
- NPI assigned
- Nov 10, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-10-7769 | VA | Primary |
Addresses
Primary practice location
5400 Shawnee Rd
Suite 208
Alexandria, VA 22312-2300
Mailing address
5400 Shawnee Rd
Suite 208
Alexandria, VA 22312-2300
Phone (703) 750-0633
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289347200000",
"number": "1063713808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5400 SHAWNEE RD",
"address_2": "SUITE 208",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223122300",
"telephone_number": "703-750-0633",
"fax_number": "703-750-0655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 SHAWNEE RD",
"address_2": "SUITE 208",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223122300",
"telephone_number": "703-750-0633",
"fax_number": "703-750-0655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIVELBISS",
"first_name": "KATIE",
"credential": "M.S., B.C.B.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-10",
"last_updated": "2010-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "VA",
"license": "1-10-7769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.