Individual provider Active NPI

Melissa Marion Boerio

  • Assistant Behavior Analyst
  • Summerville, SC
National Provider Identifier
1518544469
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
RBT-20-114726 Issued in SC
Practice address
313 Witch Hazel St
Summerville, SC 29486-6978
Phone
(720) 839-6320
NPI assigned
Mar 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X RBT-20-114726 SC Primary

Addresses

Primary practice location

313 Witch Hazel St
Summerville, SC 29486-6978

Mailing address

313 Witch Hazel St
Summerville, SC 29486-6978

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
RBT-20-114726SCMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1518544469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 WITCH HAZEL ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294866978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 WITCH HAZEL ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294866978",
            "telephone_number": "720-839-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERIO",
        "first_name": "MELISSA",
        "middle_name": "MARION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "SC",
            "license": "RBT-20-114726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.