Individual provider Active NPI

William Listello

  • Behavior Analyst
  • Cocoa, FL
National Provider Identifier
1801227640
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-16690
Practice address
453 King St
Cocoa, FL 32922-7621
Phone
(321) 633-5511
NPI assigned
Dec 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-14-16690 Primary

Addresses

Primary practice location

453 King St
Cocoa, FL 32922-7621

Mailing address

6461 Borasco Dr
Apt 2802
Melbourne, FL 32940-6143

Electronic endpoints 3

TypeEndpointUseAffiliation
Other URL N/A
Other URL n/a
Other URL n/a

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weevolve, LLC Behavior Analyst CurrentSince Jan 12, 2025 Accepting new patients

Locations

2500 N Military Trl
Ste 304
Boca Raton, FL 33431
Phone (561) 421-5111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1801227640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6461 BORASCO DR",
            "address_2": "APT 2802",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329406143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 KING ST",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227621",
            "telephone_number": "321-633-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTELLO",
        "first_name": "WILLIAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-04",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-14-16690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "453 King St",
            "city": "Cocoa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329227621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "453 King St",
            "city": "Cocoa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329227621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "453 King St",
            "city": "Cocoa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329227621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.