Heidi Lano Licudan

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0134000621 Issued in VA

Practice address

4001 Virginia Beach Blvd Ste 117
Virginia Beach, VA 23452-1759

Phone

(855) 832-6727

Fax

(772) 675-9100

NPI assigned

Jun 27, 2019

Last updated

Sep 18, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1457912537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 ANNAKA LOOP",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233232111",
            "telephone_number": "757-403-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 VIRGINIA BEACH BLVD STE 117",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521759",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICUDAN",
        "first_name": "HEIDI",
        "middle_name": "LANO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "VA",
            "license": "0134000621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assistant Behavior Analyst in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Assistant Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.