Mindy Lee Coolidge, MSED, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

001415 Issued in NY

Practice address

120 E 73Rd St Apt 1B
New York, NY 10021-4259

Phone

(518) 570-8101

NPI assigned

Aug 20, 2012

Last updated

Aug 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1326396532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 WESTCHESTER AVE",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731346",
            "telephone_number": "518-570-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 73RD ST APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214259",
            "telephone_number": "518-570-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLIDGE",
        "first_name": "MINDY",
        "middle_name": "LEE",
        "credential": "MSED, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "001415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in New York, NY
• Providers in New York, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.