Juliana Ward Suppa

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-37173 Issued in ND

Practice address

891 Belsly Blvd
Moorhead, MN 56560-5055

Phone

(218) 287-4338

Fax

(218) 287-5928

NPI assigned

Jul 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679096069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 BELSLY BLVD",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605055",
            "telephone_number": "218-287-4338",
            "fax_number": "218-287-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 BELSLY BLVD",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605055",
            "telephone_number": "218-287-4338",
            "fax_number": "218-287-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD SUPPA",
        "first_name": "JULIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2022-07-21",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "ND",
            "license": "1-19-37173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wanda C Walseth, M.S., CCC-SLP
• Anika Lauren Walstrom, M.ED., LPCC
• Erin S Walters, RD
• Jacob Wandersee
• Brydon Thomas Wanner
• Hajah Eve Washington
• Erika Weaver
• Anna Webber
• Katelyn Weber
• Alexandra Erin Wede

• Behavior Analyst in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Behavior Analyst in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.