Andrea Manfredi

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-49867 Issued in FL

Practice address

1675 Hickory Loop
Las Cruces, NM 88005-6587

Phone

(575) 652-3155

NPI assigned

Sep 20, 2018

Sex

Female

Sole proprietor

Yes

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": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1730663105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PERKINS DR STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053248",
            "telephone_number": "575-232-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 HICKORY LOOP",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880056587",
            "telephone_number": "575-652-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANFREDI",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-21-49867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas J Mallari, PT
• Dana Sue Malone, MA
• Christina Malpica
• April Anne Mancha, LMT
• Zachary Manes, PTA
• Genevieve Mann
• John Edward Mann, CASE MANAGER
• Trina Mann
• Jessica Manning, LPN
• Brittney Manquero, SLP-CCC

• Behavior Analyst in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Behavior Analyst in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.