NPIMap

Individual provider Active NPI

Lianne Zatezalo, M.ED, BCBA

  • Behavior Analyst
  • Shepherdstown, WV
National Provider Identifier
1487039715
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-38343 Issued in TX
Practice address
223 Heritage Dr
Shepherdstown, WV 25443-4560
Phone
(361) 441-3021
NPI assigned
Jul 28, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

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
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
Including Kids, Inc Past Accepting new patients
Including Kids, Inc. Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-19-38343 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

223 Heritage Dr
Shepherdstown, WV 25443-4560

Mailing address

223 Heritage Dr
Shepherdstown, WV 25443-4560
Phone (361) 441-3021

Other practice location 1

5364 Fm 1960 Rd E
Humble, TX 77346-2502
Phone (281) 852-0501

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 28, 2020.

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1487039715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 HERITAGE DR",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254434560",
            "telephone_number": "361-441-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 HERITAGE DR",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254434560",
            "telephone_number": "361-441-3021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5364 Fm 1960 Rd E",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773462502",
            "country_code": "US",
            "telephone_number": "281-852-0501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZATEZALO",
        "first_name": "LIANNE",
        "credential": "M.ED, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-19-38343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdstown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.