Active NPI
Alessandra Feola Demopoulos, BCBA
- Behavior Analyst
- Port St Lucie, FL
National Provider Identifier
1780137919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BACB335660
- Practice address
- 2616 SW Union Ter
Port St Lucie, FL 34953-2982 - Phone
- (772) 215-8679
- NPI assigned
- Jul 23, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | D514006886640 | FL | |
| Behavior Analyst | 103K00000X | BACB335660 | FL | Primary |
Addresses
Primary practice location
2616 SW Union Ter
Port St Lucie, FL 34953-2982
Mailing address
2616 SW Union Ter
Port St Lucie, FL 34953-2982
Phone (772) 215-8679
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 |
|---|---|---|---|
| BACB335660 | FL | MD | Behavioral Analyst |
| D514006886640 | FL | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1780137919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2616 SW UNION TER",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349532982",
"telephone_number": "772-215-8679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2616 SW UNION TER",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349532982",
"telephone_number": "772-215-8679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMOPOULOS",
"first_name": "ALESSANDRA",
"middle_name": "FEOLA",
"name_prefix": "Mrs.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-23",
"last_updated": "2024-03-18",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "FL",
"license": "D514006886640",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "BACB335660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.