Individual provider Active NPI

Dejah Morales

  • Assistant Behavior Analyst
  • Revere, MA
National Provider Identifier
1407421670
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
NONE Issued in MA
Practice address
31 Derby Rd Apt 1
Revere, MA 02151-1801
Phone
(857) 753-8048
NPI assigned
May 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X NONE MA Primary

Addresses

Primary practice location

31 Derby Rd Apt 1
Revere, MA 02151-1801

Mailing address

31 Derby Rd Apt 1
Revere, MA 02151-1801
Phone (857) 753-8048

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
NONEMAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1407421670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 DERBY RD APT 1",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021511801",
            "telephone_number": "857-753-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 DERBY RD APT 1",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021511801",
            "telephone_number": "857-753-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "DEJAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "MA",
            "license": "NONE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.