Individual provider Active NPI

Magdeline De la Cruz Lago, BCABA

  • Assistant Behavior Analyst
  • St Petersburg, FL
National Provider Identifier
1063900462
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-19-10590 Issued in FL
Practice address
5701 Bahia del Mar Cir Apt 401
St Petersburg, FL 33715-2357
Phone
(727) 278-1171
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-19-10590 FL Primary

Addresses

Primary practice location

5701 Bahia del Mar Cir Apt 401
St Petersburg, FL 33715-2357

Mailing address

5701 Bahia del Mar Cir Apt 401
St Petersburg, FL 33715-2357
Phone (727) 278-1171

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Horizons Behavior Therapy CurrentSince Aug 17, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1063900462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BAHIA DEL MAR CIR APT 401",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337152357",
            "telephone_number": "727-278-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BAHIA DEL MAR CIR APT 401",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337152357",
            "telephone_number": "727-278-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ LAGO",
        "first_name": "MAGDELINE",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-19-10590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.