Individual provider Active NPI

Micaela Marie Serafini

  • Behavior Analyst
  • Deerfield, IL
National Provider Identifier
1538730643
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
RBT-21-158316 Issued in IL
Practice address
707 Lake Cook Rd Ste 314
Deerfield, IL 60015-4933
Phone
(888) 981-7789
NPI assigned
Jul 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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 RBT-21-158316 IL Primary

Addresses

Primary practice location

707 Lake Cook Rd Ste 314
Deerfield, IL 60015-4933

Mailing address

950 Lee St Ste 210
Des Plaines, IL 60016-6574

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-21-158316ILMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1538730643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 LEE ST STE 210",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 LAKE COOK RD STE 314",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154933",
            "telephone_number": "888-981-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERAFINI",
        "first_name": "MICAELA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "RBT-21-158316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.