Active NPI
Larissa Mercadise Fears, BCBA, LBA
- Behavior Analyst
- Phoenix, AZ
National Provider Identifier
1639851454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BEH-001154
- Practice address
- 5025 E Washington St Ste 212
Phoenix, AZ 85034-7439 - Phone
- (602) 773-5775
- NPI assigned
- Aug 1, 2023
- Last updated
- Aug 1, 2023
- Sex
- Female
- 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 | BEH-001154 | AZ | Primary |
Addresses
Primary practice location
5025 E Washington St Ste 212
Phoenix, AZ 85034-7439
Mailing address
2150 S 55TH St Apt 2128
Tempe, AZ 85282-2376
Phone (480) 589-3292
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 |
|---|---|---|---|
| BEH-001154 | AZ | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690848000000",
"number": "1639851454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2150 S 55TH ST APT 2128",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852822376",
"telephone_number": "480-589-3292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5025 E WASHINGTON ST STE 212",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850347439",
"telephone_number": "602-773-5775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEARS",
"first_name": "LARISSA",
"middle_name": "MERCADISE",
"name_prefix": "Mrs.",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-01",
"last_updated": "2023-08-01",
"certification_date": "2023-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AZ",
"license": "BEH-001154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.