Kimberly Lisella

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

7778 SW Jack James Dr
Stuart, FL 34997-7249

Phone

(561) 377-0009

NPI assigned

Jul 26, 2024

Last updated

Jul 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Early Start Autism

  • Behavior Technician
  • Stuart, FL
  • NPI 1235052911
  NPD (past)

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1447088745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MELISSA BURKHARDT",
            "address_2": "11718 SE FEDERAL HWY",
            "city": "HOBE SOUND",
            "state": "FL",
            "postal_code": "33455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7778 SW JACK JAMES DR",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977249",
            "telephone_number": "561-377-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISELLA",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Edward Lippisch, D.M.D., P.A.
• Linda Jean Lippner, RN CNOR RNFA
• Avron H Lipschitz, MD
• Mea Inez Lipscomb
• Luisa Maria Liranzo
• Amanda Lisle
• Louis Steven Liszi, LPTA
• Louis M. Lit, M.D.
• Sarah Little, APRN
• Mark David Lively, D.M.D.

• Behavior Technician in Stuart, FL
• Providers in Stuart, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.