Madison Mendoza, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA60771905 Issued in WA

Practice address

4842 Johnson Point Rd NE
Olympia, WA 98516-9152

Phone

(520) 429-5022

NPI assigned

Jun 26, 2014

Last updated

Feb 19, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Madison Umphres Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bodhi ABA

  • Behavior Analyst
  • Olympia, WA
  • NPI 1851287387
  NPD Authorized official
• Basics Northwest

  • Community/Behavioral Health Agency
  • Lacey, WA
  • NPI 1396179545
  NPD (past)
• Basics NW LLC

  • Behavior Analyst
  • Raymond, WA
  • NPI 1073864849
  NPD (past)

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1578978680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4842 JOHNSON POINT RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985169152",
            "telephone_number": "360-515-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4842 JOHNSON POINT RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985169152",
            "telephone_number": "520-429-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MADISON",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "BA60771905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "UMPHRES",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Ann Mendez, REGISTERED NURSE
• Daniel Cruz Mendiola, OTRL, CHT
• Maximo Emmans Mendizabal, MT-BC
• Aaron R Mendoza, LMP
• Jairo Enrigue Mendoza, M.D.
• Claudia Meneghin, LMP
• Desiree Elese Mercado
• Kevin Mercer, CDP
• Rita L. Mercer, ARNP
• Michael James Merchant, M.D.

• Behavior Analyst in Olympia, WA
• Providers in Olympia, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.