Individual provider Active NPI

Andrea Richards

  • Behavior Analyst
  • Casselberry, FL
National Provider Identifier
1306299409
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-17-27484
Practice address
148 Wilshire Blvd
Casselberry, FL 32707-5372
Phone
(321) 972-4039
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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 1-17-27484 Primary

Addresses

Primary practice location

148 Wilshire Blvd
Casselberry, FL 32707-5372

Mailing address

148 Wilshire Blvd
Casselberry, FL 32707-5372
Phone (866) 411-6619

Other practice location 1

1200 N Central Ave
Kissimmee, FL 34741-4450
Phone (407) 978-6085

Other practice location 2

12315 Lake Underhill Rd
Orlando, FL 32828-4507
Phone (407) 964-1152

Other identifiers 1

IdentifierTypeStateIssuer
1-17-27484OtherBACB

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": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1306299409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 WILSHIRE BLVD",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075372",
            "telephone_number": "866-411-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 WILSHIRE BLVD",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075372",
            "telephone_number": "321-972-4039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Central Ave",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414450",
            "country_code": "US",
            "telephone_number": "407-978-6085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12315 Lake Underhill Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328284507",
            "country_code": "US",
            "telephone_number": "407-964-1152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-17-27484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "1-17-27484",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselberry, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.