Individual provider Active NPI

Michele Elise Michelson, LBA

  • Behavior Analyst
  • Bethpage, NY
National Provider Identifier
1477918035
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
000620 Issued in NY
Practice address
39 N Violet St
Bethpage, NY 11714-5124
Phone
(516) 473-9298
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 000620 NY Primary

Addresses

Primary practice location

39 N Violet St
Bethpage, NY 11714-5124

Mailing address

39 N Violet St
Bethpage, NY 11714-5124
Phone (516) 473-9298

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

State licenses

LicenseStateTypeSpecialty
000620NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1477918035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 N VIOLET ST",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145124",
            "telephone_number": "516-473-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 N VIOLET ST",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145124",
            "telephone_number": "516-473-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELSON",
        "first_name": "MICHELE",
        "middle_name": "ELISE",
        "credential": "LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "000620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.