Individual provider Active NPI

Lisa Raymond

  • Behavior Analyst
  • Homestead, FL
National Provider Identifier
1346661089
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12149010 Issued in FL
Practice address
2615 Fairways Dr
Homestead, FL 33035-1173
Phone
(540) 632-8331
NPI assigned
Dec 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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 12149010 FL Primary

Addresses

Primary practice location

2615 Fairways Dr
Homestead, FL 33035-1173

Mailing address

1311 W Golfview Dr
Pembroke Pines, FL 33026-3146
Phone (888) 880-9270

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
12149010FLMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1387843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1346661089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 W GOLFVIEW DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263146",
            "telephone_number": "888-880-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 FAIRWAYS DR",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330351173",
            "telephone_number": "540-632-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-24",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "12149010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.