Individual provider Active NPI

Melissa Margaret Walker, BCBA, LBA-CT

  • Behavior Analyst
  • Shelton, CT
National Provider Identifier
1396359873
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
893 Issued in CT
Practice address
10 Progress Dr Ste 2B
Shelton, CT 06484-6294
Phone
(475) 239-5512
NPI assigned
Sep 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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 893 CT Primary

Addresses

Primary practice location

10 Progress Dr Ste 2B
Shelton, CT 06484-6294

Mailing address

515 West Ave
MB 203
Norwalk, CT 06850
Phone (203) 240-1537

Other identifiers 2

IdentifierTypeStateIssuer
1-19-38094OtherBACB CERTIFICATION
893OtherCTLICENSED BEHAVIOR ANALYST

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

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Pathology Group LLC CurrentSince Nov 10, 2024 Accepting new patients

Locations

10 Progress Dr
Ste 2B
Shelton, CT 06484
Phone (203) 949-9337

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1396359873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 WEST AVE",
            "address_2": "MB 203",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "06850",
            "telephone_number": "203-240-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PROGRESS DR STE 2B",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846294",
            "telephone_number": "475-239-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MELISSA",
        "middle_name": "MARGARET",
        "credential": "BCBA, LBA-CT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB CERTIFICATION",
            "identifier": "1-19-38094",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED BEHAVIOR ANALYST",
            "identifier": "893",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

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

Verify at the official NPI Registry.