Lisette Angelica Roldan, LABA, BCABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0134000565 Issued in VA

Practice address

405 Yorkshire St
Salem, VA 24153-7016

Phone

(540) 285-0699

NPI assigned

Nov 18, 2024

Last updated

Nov 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1659196442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 YORKSHIRE ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537016",
            "telephone_number": "540-285-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 YORKSHIRE ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537016",
            "telephone_number": "540-285-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLDAN",
        "first_name": "LISETTE",
        "middle_name": "ANGELICA",
        "credential": "LABA, BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0134000565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Roderique, RN
• Gisette Rodriguez, MD
• Angela Young Rogers, PA-C
• John W Rogers, M.D.
• Juanita Louise Rogers, MSW
• Shannon Roosma, LPC
• Sidney Rorrer
• Julia Marie Rose, NP-C
• Katlen Manning Rosen, FNP
• Martha Ross

• Behavior Analyst in Salem, VA
• Providers in Salem, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.