Deirdre M. Weatherston, MSED, RBT, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-15-20674 Issued in CO

Practice address

351 Dover St
Westbury, NY 11590-3205

Phone

(917) 882-0429

NPI assigned

Nov 20, 2015

Last updated

Jan 16, 2016By 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 2

Addresses

Other names 1

• Deirdre M. Clancy Former name

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": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452902400000",
    "number": "1477927937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 DOVER ST",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115903205",
            "telephone_number": "917-882-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 DOVER ST",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115903205",
            "telephone_number": "917-882-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERSTON",
        "first_name": "DEIRDRE",
        "middle_name": "M.",
        "credential": "MSED, RBT, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2016-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-15-20674",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1196",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEIRDRE",
            "last_name": "CLANCY",
            "middle_name": "M.",
            "credential": "MSED, RBT, BCBA, LBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Analyst in Westbury, NY
• Providers in Westbury, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2016; 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.