Juan Manuel Mondillo

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

4 Cloverleaf CT
Fredericksburg, VA 22406-7269

Phone

(703) 508-8043

Fax

(540) 301-8315

NPI assigned

Jul 13, 2019

Last updated

Jan 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Driven Behavioral Support LLC

  • Behavior Analyst
  • Spotsylvania, VA
  • NPI 1831732486
  NPD Authorized official

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

{
    "created_epoch": "1562976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1538711148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 LONG LEAF CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224075083",
            "telephone_number": "540-479-7823",
            "fax_number": "540-301-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CLOVERLEAF CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224067269",
            "telephone_number": "703-508-8043",
            "fax_number": "540-301-8315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10900 Long Leaf Ct",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224075083",
            "country_code": "US",
            "telephone_number": "540-479-7823",
            "fax_number": "540-301-8315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONDILLO",
        "first_name": "JUAN",
        "middle_name": "MANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-13",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patti Dye Mohs, PTA
• Saniya Mohsin, MD
• Matthew Thomas Moleski-Belski, PT, DPT
• Gabrielle Maria Monaco, PA-C
• Monday Courage LLC
• Aaron Jason Monroe, BS, QMHP, RPRS
• Tomilola O Monroe, NP
• Brandy A Montague
• Elizabeth Anne Montana, LCSW
• Montgomery Johns, MD, Facog, LTD. (Center for Advanced Women's Medicine)

• Behavior Analyst in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.