Derek Colucci, MS, LBS

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BH005968 Issued in PA

Practice address

1990 W 3Rd St
Williamsport, PA 17701-7808

Phone

(570) 320-2816

NPI assigned

Aug 31, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1841910619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 W MAIN ST",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177451122",
            "telephone_number": "570-295-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 W 3RD ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177017808",
            "telephone_number": "570-320-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLUCCI",
        "first_name": "DEREK",
        "name_prefix": "Mr.",
        "credential": "MS, LBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH005968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian D Cole, MD
• Lexis Colescott, OTR/L
• Leonard R Collins, M.D.
• Ryan Allen Collins, MD
• Mark L. Collister, L.S.W.
• Megan Colvin
• Morgan Rene Confer, PHARMD., RPH.
• Amanda May Connelly, LMT
• Daniel R Conner, DO
• Shelly Marie Conner, CRNP

• Behavior Analyst in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.