Melissa Tice Martin, BACB

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

27 Lighthouse Dr
Rehoboth Beach, DE 19971-9575

Phone

(302) 245-9262

NPI assigned

Jul 20, 2024

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

Other names 1

• Mrs. Melissa Ann Tice Martin Other name

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": "1721433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721433600000",
    "number": "1720826944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 LIGHTHOUSE DR",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199719575",
            "telephone_number": "302-245-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 LIGHTHOUSE DR",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199719575",
            "telephone_number": "302-245-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MELISSA",
        "middle_name": "TICE",
        "name_prefix": "Mrs.",
        "credential": "BACB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-20",
        "last_updated": "2024-07-20",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MARTIN",
            "middle_name": "ANN TICE",
            "prefix": "MRS.",
            "credential": "BCBA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Behavior Analyst in Rehoboth Beach, DE
• Providers in Rehoboth Beach, DE by specialty
• Behavior Analyst in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.