Active NPI
Marilyn Lande
- Behavior Analyst
- Bernalillo, NM
National Provider Identifier
1447579404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 301 S Camino del Pueblo
Bernalillo, NM 87004-6276 - Phone
- (505) 867-2383
- Fax
- (505) 867-7293
- NPI assigned
- May 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | NM | Primary |
Addresses
Primary practice location
301 S Camino del Pueblo
Bernalillo, NM 87004-6276
Mailing address
301 S Camino del Pueblo
Bernalillo, NM 87004-6276
Phone (505) 867-2383
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85-0206810 | Medicaid | NM |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398643200000",
"number": "1447579404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 S CAMINO DEL PUEBLO",
"city": "BERNALILLO",
"state": "NM",
"postal_code": "870046276",
"telephone_number": "505-867-2383",
"fax_number": "505-867-7293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S CAMINO DEL PUEBLO",
"city": "BERNALILLO",
"state": "NM",
"postal_code": "870046276",
"telephone_number": "505-867-2383",
"fax_number": "505-867-7293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDE",
"first_name": "MARILYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-28",
"last_updated": "2014-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NM",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "85-0206810",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bernalillo, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.