Active NPI
Elizabeth Gennari
- Behavior Analyst
- Lakeland, FL
National Provider Identifier
1396141297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11622452
- Practice address
- 1857 N Crystal Lake Dr
Lakeland, FL 33801-5955 - Phone
- (863) 337-5056
- Fax
- (863) 337-4891
- NPI assigned
- Nov 5, 2014
- Last updated
- Dec 10, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11622452 | FL | Primary |
Addresses
Primary practice location
1857 N Crystal Lake Dr
Lakeland, FL 33801-5955
Mailing address
1857 N Crystal Lake Dr
Lakeland, FL 33801-5955
Phone (863) 337-5056
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11622452 | FL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Matter ABA Solutions, LLC | Current | Accepting new patients |
Locations
1857 N Crystal Lake Dr
Lakeland, FL 33801
Phone (863) 337-5056
Organizations & group practices 1
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.
-
- Behavior Technician
- Lakeland, FL
- NPI 1649059833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1396141297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1857 N CRYSTAL LAKE DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338015955",
"telephone_number": "863-337-5056",
"fax_number": "863-337-4891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1857 N CRYSTAL LAKE DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338015955",
"telephone_number": "863-337-5056",
"fax_number": "863-337-4891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENNARI",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-05",
"last_updated": "2024-12-10",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "11622452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.