Active NPI
Michael De Vito Jr.
- Behavior Technician
- Vienna, VA
National Provider Identifier
1497230080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1964 Gallows Rd Ste 280
Vienna, VA 22182-3877 - Phone
- (571) 533-3456
- Fax
- (855) 832-0430
- NPI assigned
- Sep 28, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1964 Gallows Rd Ste 280
Vienna, VA 22182-3877
Mailing address
11059 E Bethany Dr
Aurora, CO 80014-2622
Phone (303) 617-2365
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1497230080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11059 E BETHANY DR",
"city": "AURORA",
"state": "CO",
"postal_code": "800142622",
"telephone_number": "303-617-2365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1964 GALLOWS RD STE 280",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823877",
"telephone_number": "571-533-3456",
"fax_number": "855-832-0430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE VITO",
"first_name": "MICHAEL",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-28",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.