Individual provider Active NPI

Larissa Kavitsky

  • Behavior Analyst
  • Valley Stream, NY
National Provider Identifier
1487044038
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
509507977 Issued in NY
Practice address
24 Gale Dr
Valley Stream, NY 11581-3623
Phone
(516) 592-0582
NPI assigned
Feb 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 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 509507977 NY Primary

Addresses

Primary practice location

24 Gale Dr
Valley Stream, NY 11581-3623

Mailing address

24 Gale Dr
Valley Stream, NY 11581-3623
Phone (516) 592-0582

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
509507977NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1487044038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 GALE DR",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813623",
            "telephone_number": "516-592-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 GALE DR",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813623",
            "telephone_number": "516-592-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVITSKY",
        "first_name": "LARISSA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "509507977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.