Active NPI
Marissa Allen, BCBA, LBA
- Behavior Analyst
- Bellevue, WA
National Provider Identifier
1104591551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA.BA.61555256
- Practice address
- 2310 130TH Ave NE Ste 100
Bellevue, WA 98005-1757 - Phone
- (425) 882-8868
- NPI assigned
- Aug 9, 2021
- Last updated
- Apr 28, 2024
- 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 | LBA.BA.61555256 | WA | Primary |
Addresses
Primary practice location
2310 130TH Ave NE Ste 100
Bellevue, WA 98005-1757
Mailing address
7016 15TH Ave NW Unit 113
Seattle, WA 98117-5589
Phone (206) 890-8895
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
| License | State | Type | Specialty |
|---|---|---|---|
| LBA.BA.61555256 | WA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sum of Learning, LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Bellevue, WA
- NPI 1033525084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714262400000",
"number": "1104591551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7016 15TH AVE NW UNIT 113",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981175589",
"telephone_number": "206-890-8895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 130TH AVE NE STE 100",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980051757",
"telephone_number": "425-882-8868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "MARISSA",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-09",
"last_updated": "2024-04-28",
"certification_date": "2024-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "LBA.BA.61555256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.