Individual provider Active NPI

Corrine Girondo, MS. LBS., BCBA

  • Behavior Analyst
  • Blue Bell, PA
National Provider Identifier
1386155190
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BACB228209 Issued in CO
Practice address
5 Sentry Pkwy E Ste 200
Blue Bell, PA 19422-2307
Phone
(267) 465-7615
NPI assigned
Oct 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 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 BACB228209 CO Primary

Addresses

Primary practice location

5 Sentry Pkwy E Ste 200
Blue Bell, PA 19422-2307

Mailing address

142 Fawn Dr
Gilbertsville, PA 19525-8102
Phone (570) 205-0407

Other practice location 1

142 Fawn Dr
Gilbertsville, PA 19525-8102
Phone (570) 205-0407

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
BACB228209COMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1386155190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 FAWN DR",
            "city": "GILBERTSVILLE",
            "state": "PA",
            "postal_code": "195258102",
            "telephone_number": "570-205-0407",
            "fax_number": "570-205-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SENTRY PKWY E STE 200",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222307",
            "telephone_number": "267-465-7615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 Fawn Dr",
            "address_purpose": "LOCATION",
            "city": "Gilbertsville",
            "state": "PA",
            "postal_code": "195258102",
            "country_code": "US",
            "telephone_number": "570-205-0407",
            "fax_number": "570-205-0407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIRONDO",
        "first_name": "CORRINE",
        "name_prefix": "Mrs.",
        "credential": "MS. LBS., BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "BACB228209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

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