Individual provider Active NPI

Tenisa Turnbaugh, BCBA

  • Behavior Analyst
  • Lyndonville, VT
National Provider Identifier
1578993010
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0125076 Issued in VT
Practice address
2335 Peak Rd
Lyndonville, VT 05851-9546
Phone
(203) 233-5497
Fax
(888) 920-3282
NPI assigned
Nov 20, 2013
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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 0125076 VT Primary

Addresses

Primary practice location

2335 Peak Rd
Lyndonville, VT 05851-9546

Mailing address

2335 Peak Rd
Lyndonville, VT 05851-9546
Phone (802) 233-5497

Other practice location 1

34 Deer Hill Rd
Southbury, CT 06488-1124
Phone (203) 233-5497

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
0125076VTMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Illumine Collaborative, LLC Behavior Analyst CurrentSince Dec 12, 2021 Accepting new patients
SD Associates, LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1578993010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 PEAK RD",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058519546",
            "telephone_number": "802-233-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 PEAK RD",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058519546",
            "telephone_number": "203-233-5497",
            "fax_number": "888-920-3282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Deer Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Southbury",
            "state": "CT",
            "postal_code": "064881124",
            "country_code": "US",
            "telephone_number": "203-233-5497",
            "fax_number": "888-920-3282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TURNBAUGH",
        "first_name": "TENISA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-20",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VT",
            "license": "0125076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndonville, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.