Daphne Gilliam, BCABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0134000251 Issued in VA

Practice address

1138 2ND St SW
Roanoke, VA 24016-4725

Phone

(980) 785-1113

Fax

(980) 785-1114

NPI assigned

Dec 12, 2017

Last updated

Feb 23, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mosaic Group, LLC

  dba Mosaic Pediatric Therapy

  • Behavior Analyst
  • Pineville, NC
  • NPI 1144682873
  NPD (past)

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1326553470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 LEE HWY",
            "city": "TROUTVILLE",
            "state": "VA",
            "postal_code": "241755919",
            "telephone_number": "540-580-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 2ND ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164725",
            "telephone_number": "980-785-1113",
            "fax_number": "980-785-1114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3243 Electric Rd Bldg E",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240186440",
            "country_code": "US",
            "telephone_number": "540-404-1189",
            "fax_number": "540-904-0096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "DAPHNE",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "VA",
            "license": "0134000251",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "RBT-17-33544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gill Memorial ENT Clinic, PC
• Katherine Julie Gill, NP
• Jacob R Gillen, MD
• Amanda Lynn Gillespie-Twardy, M.D.
• Jayna Madeleine Gillespie, LPC
• Sara N Gillis, CPNP
• Jessica Spencer Gillispie, PA-C
• James Winston Gills, PA-C
• Amanda Dawn Gillum, PHARMD
• Cassidy Gilmore, DPT

• Assistant Behavior Analyst in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Assistant Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.