Active NPI
Lucas Monteiro Fortes
- Behavior Analyst
- Holbrook, MA
National Provider Identifier
1639680465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- S11669895
- Practice address
- 204 S Franklin St
Holbrook, MA 02343-1437 - Phone
- (508) 649-5952
- NPI assigned
- Oct 19, 2017
- Last updated
- Oct 19, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | S11669895 | MA | Primary |
Addresses
Primary practice location
204 S Franklin St
Holbrook, MA 02343-1437
Mailing address
204 S Franklin St
Holbrook, MA 02343-1437
Phone (508) 649-5952
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
| License | State | Type | Specialty |
|---|---|---|---|
| S11669895 | MA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508371200000",
"number": "1639680465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 S FRANKLIN ST",
"city": "HOLBROOK",
"state": "MA",
"postal_code": "023431437",
"telephone_number": "508-649-5952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 S FRANKLIN ST",
"city": "HOLBROOK",
"state": "MA",
"postal_code": "023431437",
"telephone_number": "508-649-5952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTES",
"first_name": "LUCAS",
"middle_name": "MONTEIRO",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-19",
"last_updated": "2017-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "S11669895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holbrook, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.