Active NPI
Sabrena McCullough
- Behavior Analyst
- Lake Placid, FL
National Provider Identifier
1225503824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 200 Huntley Oaks Blvd
Lake Placid, FL 33852-7002 - Phone
- (863) 243-1761
- NPI assigned
- Oct 10, 2018
- Reactivated
- May 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
200 Huntley Oaks Blvd
Lake Placid, FL 33852-7002
Mailing address
200 Huntley Oaks Blvd
Lake Placid, FL 33852-7002
Phone (863) 243-1761
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557878400000",
"number": "1225503824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HUNTLEY OAKS BLVD",
"city": "LAKE PLACID",
"state": "FL",
"postal_code": "338527002",
"telephone_number": "863-243-1761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HUNTLEY OAKS BLVD",
"city": "LAKE PLACID",
"state": "FL",
"postal_code": "338527002",
"telephone_number": "863-243-1761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "SABRENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-10",
"last_updated": "2019-05-15",
"deactivation_date": "2019-03-25",
"reactivation_date": "2019-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Placid, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.