Active NPI
Heather Walus, MS
- Behavior Analyst
- Fort Myers, FL
National Provider Identifier
1417474800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 4150 Ford St Ste 4
Fort Myers, FL 33916-9498 - Phone
- (239) 291-5088
- NPI assigned
- Aug 25, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | CT | ||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
4150 Ford St Ste 4
Fort Myers, FL 33916-9498
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
Other practice location 1
85 Chapel St
Newton, MA 02458-1065
Phone (508) 363-0200
Other practice location 2
2500 Bobcat Village Center Rd Unit G
North Port, FL 34288-8476
Phone (800) 210-0814
Other practice location 3
162 West St Ste F
Cromwell, CT 06416-4405
Phone (860) 613-9930
Other practice location 4
162 West St Ste F
Cromwell, CT 06416-4405
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734912000000",
"number": "1417474800",
"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": "4150 FORD ST STE 4",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339169498",
"telephone_number": "239-291-5088"
}
],
"practiceLocations": [
{
"address_1": "85 Chapel St",
"address_purpose": "LOCATION",
"city": "Newton",
"state": "MA",
"postal_code": "024581065",
"country_code": "US",
"telephone_number": "508-363-0200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2500 Bobcat Village Center Rd Unit G",
"address_purpose": "LOCATION",
"city": "North Port",
"state": "FL",
"postal_code": "342888476",
"country_code": "US",
"telephone_number": "800-210-0814",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "162 West St Ste F",
"address_purpose": "LOCATION",
"city": "Cromwell",
"state": "CT",
"postal_code": "064164405",
"country_code": "US",
"telephone_number": "860-613-9930",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "162 West St Ste F",
"address_purpose": "LOCATION",
"city": "Cromwell",
"state": "CT",
"postal_code": "064164405",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALUS",
"first_name": "HEATHER",
"name_prefix": "Miss",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-25",
"last_updated": "2024-12-23",
"certification_date": "2024-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "CT",
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.