Individual provider Active NPI

Leah Marie Roselli

  • Behavior Technician
  • Woburn, MA
National Provider Identifier
1407347511
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
S29250248 Issued in MA
Practice address
331 Montvale Ave
Woburn, MA 01801-4675
Phone
(781) 281-7601
NPI assigned
May 24, 2018
Last updated
May 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X S29250248 MA Primary

Addresses

Primary practice location

331 Montvale Ave
Woburn, MA 01801-4675

Mailing address

21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (818) 345-2345

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
S29250248MAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1407347511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST STE 1800",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677807",
            "telephone_number": "818-345-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 MONTVALE AVE",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018014675",
            "telephone_number": "781-281-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSELLI",
        "first_name": "LEAH",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MA",
            "license": "S29250248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.