Individual provider Active NPI

Roberta Carol Maresh

  • Behavior Analyst
  • Austin, TX
National Provider Identifier
1639053937
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BACB955927 Issued in TX
Practice address
7801 N Lamar Blvd Ste B168
Austin, TX 78752-1031
Phone
(512) 387-0205
NPI assigned
Aug 1, 2025
Last updated
Aug 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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 BACB955927 TX Primary

Addresses

Primary practice location

7801 N Lamar Blvd Ste B168
Austin, TX 78752-1031

Mailing address

2104 E Anderson LN Apt 1416
Austin, TX 78752-1951
Phone (763) 898-9113

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
BACB955927TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Identity CurrentSince Aug 3, 2025 Accepting new patients

Locations

7801 N Lamar Blvd
Ste B168
Austin, TX 78752
Phone (512) 387-0205

Organizations & group practices 1

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": "1754006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1639053937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 E ANDERSON LN APT 1416",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787521951",
            "telephone_number": "763-898-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 N LAMAR BLVD STE B168",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787521031",
            "telephone_number": "512-387-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARESH",
        "first_name": "ROBERTA",
        "middle_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "BACB955927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

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