Lisa Gravatt, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-14-15619 Issued in MD

Practice address

22593 Three Notch Rd
California, MD 20619-3054

Phone

(301) 862-2505

Fax

(301) 862-2548

NPI assigned

Nov 11, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Personalized Therapy, LLC

  • Behavior Analyst
  • California, MD
  • NPI 1174005698
  NPD (past)

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1174929699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22593 THREE NOTCH RD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193054",
            "telephone_number": "301-862-2505",
            "fax_number": "301-862-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22593 THREE NOTCH RD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193054",
            "telephone_number": "301-862-2505",
            "fax_number": "301-862-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVATT",
        "first_name": "LISA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-11",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "1-14-15619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgravatt@ptherapy.net",
            "affiliation": "N",
            "address_1": "22593 Three Notch Rd",
            "city": "California",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206193054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca Gonzalez
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• Grasee, Inc.
• Michael Gray, MD
• Brianna Greenwell
• Kirstin Griffith
• Mia Griffiths
• Jenelle Gucwa, CCC SLP

• Behavior Analyst in California, MD
• Providers in California, MD by specialty
• Behavior Analyst in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.