Individual provider Active NPI

Marissa Seltman

  • Behavior Analyst
  • Tampa, FL
National Provider Identifier
1083158588
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
017423100 Issued in FL
Practice address
4511 N Himes Ave
Suite 200
Tampa, FL 33614-7074
Phone
(813) 417-7879
Fax
(813) 422-7954
NPI assigned
Dec 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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 017423100 FL Primary

Addresses

Primary practice location

4511 N Himes Ave
Suite 200
Tampa, FL 33614-7074

Mailing address

4511 N Himes Ave
Suite 200
Tampa, FL 33614-7074
Phone (813) 417-7879

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

State licenses

LicenseStateTypeSpecialty
017423100FLMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1083158588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 N HIMES AVE",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147074",
            "telephone_number": "813-417-7879",
            "fax_number": "813-422-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 N HIMES AVE",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147074",
            "telephone_number": "813-417-7879",
            "fax_number": "813-422-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELTMAN",
        "first_name": "MARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "017423100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.