Individual provider Active NPI

Craig Devincenzo

  • Behavior Analyst
  • Melbourne, FL
National Provider Identifier
1316360175
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1435 Aurora Rd
Melbourne, FL 32935-5315
Phone
(321) 977-0840
NPI assigned
Jan 30, 2014
Last updated
May 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 010074-01 NY
Mental Health Counselor 101YM0800X MH21855 FL
Mental Health Counselor 101YM0800X 37PC01141400 NJ
Professional Counselor 101YP2500X 37PC01141400 NJ
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

1435 Aurora Rd
Melbourne, FL 32935-5315

Mailing address

1435 Aurora Rd
Melbourne, FL 32935-5315

Other practice location 1

12702 Science Dr
Orlando, FL 32826-3016
Phone (407) 574-4629

Other practice location 2

588 Baylor Ave
Rivervale, NJ 07675-5926
Phone (646) 879-1251

Other practice location 3

125 E Nasa Blvd
Melbourne, FL 32901-1900
Phone (321) 345-5232

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

State licenses

LicenseStateTypeSpecialty
MH21855FLMDMental Health Counselor
010074-01NYMDMental Health Counselor
37PC01141400NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Basecamp Behavioral Therapy Mental Health Current Accepting new patients
Bierman ABA Inc. Behavior Analyst Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1316360175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 AURORA RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 AURORA RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355315",
            "telephone_number": "321-977-0840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12702 Science Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328263016",
            "country_code": "US",
            "telephone_number": "407-574-4629",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "588 Baylor Ave",
            "address_purpose": "LOCATION",
            "city": "Rivervale",
            "state": "NJ",
            "postal_code": "076755926",
            "country_code": "US",
            "telephone_number": "646-879-1251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 E Nasa Blvd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329011900",
            "country_code": "US",
            "telephone_number": "321-345-5232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVINCENZO",
        "first_name": "CRAIG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-30",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010074-01",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21855",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC01141400",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC01141400",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.