Individual provider Active NPI

Melania Petreccia

  • Behavior Technician
  • Pompano Beach, FL
National Provider Identifier
1619574340
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
1011154 Issued in FL
Practice address
916 NE 4TH St
Pompano Beach, FL 33060-6416
Phone
(954) 212-9126
NPI assigned
Oct 6, 2020
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 1011154 FL Primary

Addresses

Primary practice location

916 NE 4TH St
Pompano Beach, FL 33060-6416

Mailing address

2355 Vintage Dr
Lighthouse Point, FL 33064-6089
Phone (954) 512-0520

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
1011154FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1619574340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 VINTAGE DR",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330646089",
            "telephone_number": "954-512-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 NE 4TH ST",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330606416",
            "telephone_number": "954-212-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRECCIA",
        "first_name": "MELANIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "1011154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.