Individual provider Active NPI

Robin Dee Denicola, MS

  • Behavior Analyst
  • Melbourne, FL
National Provider Identifier
1679874374
Registry record updated Nov 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-01-0508 Issued in FL
Practice address
927 E New Haven Ave Ste 316
Melbourne, FL 32901-5417
Phone
(321) 557-1141
NPI assigned
Nov 11, 2010
Last updated
Nov 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4750 (CAP) FL
Addiction (Substance Use Disorder) Counselor 101YA0400X 703172 (IC&RC) FL
Addiction (Substance Use Disorder) Counselor 101YA0400X SAP-DOT APPROVED FL
Behavior Analyst 103K00000X 1-01-0508 FL Primary

Addresses

Primary practice location

927 E New Haven Ave Ste 316
Melbourne, FL 32901-5417

Mailing address

927 E New Haven Ave Ste 316
Melbourne, FL 32901-5417
Phone (321) 557-1141

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4750 (CAP)FLMDAddiction (Substance Use Disorder) Counselor
703172 (IC&RC)FLMDAddiction (Substance Use Disorder) Counselor
SAP-DOT APPROVEDFLMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289606400000",
    "number": "1679874374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 E NEW HAVEN AVE STE 316",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015417",
            "telephone_number": "321-557-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 E NEW HAVEN AVE STE 316",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015417",
            "telephone_number": "321-557-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENICOLA",
        "first_name": "ROBIN",
        "middle_name": "DEE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-11",
        "last_updated": "2010-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "4750 (CAP)",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "703172 (IC&RC)",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "SAP-DOT APPROVED",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-01-0508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2010; 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.