Active NPI
Lillian Roffers
- Behavior Analyst
- De Pere, WI
National Provider Identifier
1720958630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1465-140
- Practice address
- 1141 W Main Ave
De Pere, WI 54115-1695 - Phone
- (920) 338-1610
- Fax
- (920) 338-1616
- NPI assigned
- Nov 6, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1465-140 | WI | Primary |
Addresses
Primary practice location
1141 W Main Ave
De Pere, WI 54115-1695
Mailing address
6225 Smith Ave Ste 1001a
Baltimore, MD 21209-3626
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1465-140 | WI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762387200000",
"number": "1720958630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6225 SMITH AVE STE 1001A",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212093626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 W MAIN AVE",
"city": "DE PERE",
"state": "WI",
"postal_code": "541151695",
"telephone_number": "920-338-1610",
"fax_number": "920-338-1616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROFFERS",
"first_name": "LILLIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-06",
"last_updated": "2025-11-06",
"certification_date": "2025-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WI",
"license": "1465-140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Pere, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.