Individual provider Active NPI

Marlene I Hernandez-Correa

  • Behavior Analyst
  • Elkhart, IN
National Provider Identifier
1669072856
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
30380 County Road 6
Elkhart, IN 46514-9514
Phone
(574) 343-2001
NPI assigned
Oct 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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 Primary

Addresses

Primary practice location

30380 County Road 6
Elkhart, IN 46514-9514

Mailing address

2550 N Hollywood Way Ste 102
Burbank, CA 91505-5031
Phone (866) 727-8274

Other practice location 1

475 S John Rodes Blvd
Melbourne, FL 32904-1093
Phone (321) 241-1170

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

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Spectrum Therapies, LLC Behavior Analyst PastSince Jan 21, 2022 Accepting new patients
The Sonder Academy Behavior Analyst PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1669072856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N HOLLYWOOD WAY STE 102",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915055031",
            "telephone_number": "866-727-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30380 COUNTY ROAD 6",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465149514",
            "telephone_number": "574-343-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 S John Rodes Blvd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329041093",
            "country_code": "US",
            "telephone_number": "321-241-1170",
            "fax_number": "321-241-1171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ-CORREA",
        "first_name": "MARLENE",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.