Individual provider Active NPI

Ashlee Mallery, BCBA

  • Behavior Analyst
  • Bloomsburg, PA
National Provider Identifier
1205780822
Registry record updated Feb 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
112 Hemlock LN
Bloomsburg, PA 17815-9105
Phone
(570) 394-0832
NPI assigned
Feb 21, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2026

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 Primary

Addresses

Primary practice location

112 Hemlock LN
Bloomsburg, PA 17815-9105

Mailing address

390 E Grove St
Nanticoke, PA 18634-3538

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
Pave the Way ABA Behavior Analyst PastSince Aug 18, 2024 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": "1771632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771632000000",
    "number": "1205780822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 E GROVE ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186343538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HEMLOCK LN",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178159105",
            "telephone_number": "570-394-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLERY",
        "first_name": "ASHLEE",
        "name_prefix": "Miss",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-21",
        "last_updated": "2026-02-21",
        "certification_date": "2026-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2026; 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.