Sally Lee Smith, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

6411 SW Lee Bailey Landing Rd
Blountstown, FL 32424-5613

Phone

(850) 372-3729

NPI assigned

Apr 11, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sally Denise Lee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1285098756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 SW LEE BAILEY LANDING RD",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324245613",
            "telephone_number": "850-372-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 SW LEE BAILEY LANDING RD",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324245613",
            "telephone_number": "850-372-3729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12427 NW Pea Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "FL",
            "postal_code": "323213494",
            "country_code": "US",
            "telephone_number": "850-372-3729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SALLY",
        "middle_name": "LEE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "LEE",
            "middle_name": "DENISE",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Blountstown, FL
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.