Amanda Michelle Fernandez, MA, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BEH-000975 Issued in AZ

Practice address

5859 W Talavi Blvd Ste 180
Glendale, AZ 85306-1873

Phone

(602) 560-2836

Fax

(317) 520-8200

NPI assigned

Aug 4, 2020

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

Other identifiers 1

Other names 1

• Amanda Michelle Lacount Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1396355459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 W TALAVI BLVD STE 180",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061873",
            "telephone_number": "602-560-2836",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AZ",
            "license": "RBT-20-120709",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-000975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-22-60394",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "LACOUNT",
            "middle_name": "MICHELLE",
            "credential": "BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melynda Fenn, NP
• Meghan Maureen Fenske, PA-C
• Marisa Feore
• Bruce Fergen, FNP
• Melissa Ferguson
• Chance Fernandez, RBT, BS
• Gema Elizabeth Fernandez, M.D.
• Monica Fernandez, PA-C
• Ruby Esmeralda Fernandez, NP
• Haley Ann Ferralez

• All providers in Glendale, AZ
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.