Individual provider Active NPI

Debra Ann Dallman, MS, BCBA, LBA

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1790144426
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BEH-000629 Issued in AZ
Practice address
1840 N 95TH Ave Ste 140
Phoenix, AZ 85037-4446
Phone
(623) 264-8188
Fax
(317) 520-8200
NPI assigned
Feb 23, 2016
Last updated
Jul 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BEH-000629 AZ Primary
Behavior Analyst 103K00000X 1-20-42614

Addresses

Primary practice location

1840 N 95TH Ave Ste 140
Phoenix, AZ 85037-4446

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other practice location 1

3712 MacArthur Blvd Ste 100
New Orleans, LA 70114-6861
Phone (504) 882-8105

Other practice location 2

1704 Westland Rd
Cheyenne, WY 82001-3322
Phone (307) 222-2400

Other practice location 3

8550 United Plaza Blvd Ste 702N
Baton Rouge, LA 70809-0200
Phone (951) 329-0662

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
BEH-000629AZMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleidoscope Family Solutions ABA Inc. Behavior Analyst PastSince May 28, 2023 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1790144426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 N 95TH AVE STE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374446",
            "telephone_number": "623-264-8188",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3712 MacArthur Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701146861",
            "country_code": "US",
            "telephone_number": "504-882-8105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1704 Westland Rd",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820013322",
            "country_code": "US",
            "telephone_number": "307-222-2400",
            "fax_number": "605-271-3956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8550 United Plaza Blvd Ste 702N",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708090200",
            "country_code": "US",
            "telephone_number": "951-329-0662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALLMAN",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "MS, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-000629",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-20-42614",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.