Carissa Elizabeth Gilliland, M.ED., BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BEH-000496 Issued in AZ

Practice address

2400 W Dunlap Ave Ste 100
Phoenix, AZ 85021-2813

Phone

(602) 325-2485

NPI assigned

Feb 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Carissa Elizabeth Tharp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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

• Center for Autism & Related Disorders, LLC

  • Behavior Analyst
  • Phoenix, AZ
  • NPI 1104573807
  NPD (past)

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1457850489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 N 108TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375469",
            "telephone_number": "480-751-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W DUNLAP AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212813",
            "telephone_number": "602-325-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "CARISSA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "M.ED., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-000496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "THARP",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Griselda Gillett, LPC
• Jeffrey Gilliam, MSW
• Theresa M Gilliam
• Stephany Gillie
• James P Gilligan, MSN, ACNP-BC
• Jared Murphy Gilliland, DDS
• John E. Gillis, D.M.D.
• John Malcolm Gillis, DMD
• Tracey Gillispie, NNP
• Kate M Gillpatrick, DO

• Behavior Analyst in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.