Mercedies-Marie Mikala O'Connor, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-58192 Issued in VA

Practice address

14059 Crown CT
Woodbridge, VA 22193-1458

Phone

(866) 565-7222

Fax

(877) 734-1914

NPI assigned

Jan 7, 2019

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 identifiers 1

Other names 1

• Mercedies-Marie Mikala McCalla-Simmonds Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Your Life ABA VA, LLC

  • Behavior Analyst
  • New York, NY
  • NPI 1023772001
  NPD (past)

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1760955322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 VILLAGE SQ STE 210",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212101624",
            "telephone_number": "609-525-4271",
            "fax_number": "443-743-3863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14059 CROWN CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931458",
            "telephone_number": "866-565-7222",
            "fax_number": "877-734-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "MERCEDIES-MARIE",
        "middle_name": "MIKALA",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "1-22-58192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760955322",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MERCEDIES-MARIE",
            "last_name": "MCCALLA-SIMMONDS",
            "middle_name": "MIKALA",
            "credential": "BCBA, LBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nyava Healthcare & in Home Services
• Rumbidzayi Nzara Mukurazhizha, M.D.
• Gavin Meeks O'Brien
• Jerome Thomas O'Connell Jr., M.D.
• Janet O'Connor, M.D.
• Maureen Theresa O'Dea, M.D.
• Maria O'Loughlin
• Rosemary O'Neill, NNP
• Oakhill Home Health Inc
• Oasis Nexcare Medical LLC

• Behavior Analyst in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.