Tanisha Marie Phillips, RBT

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

15270170 Issued in VA

Practice address

703 Godwin St
Portsmouth, VA 23704-4009

Phone

(757) 227-7708

NPI assigned

Apr 13, 2022

Sex

Female

Sole proprietor

Yes

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

• Tanisha Marie Phillips Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1851034326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GODWIN ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237044009",
            "telephone_number": "757-227-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 GODWIN ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237044009",
            "telephone_number": "757-227-7708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 Godwin St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237044009",
            "country_code": "US",
            "telephone_number": "757-227-7708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TANISHA",
        "middle_name": "MARIE",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "15270170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15270170",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANISHA",
            "last_name": "PHILLIPS",
            "middle_name": "MARIE",
            "credential": "RBT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tri Dai Pham
• Clarence David Phaup Jr.
• Sohila Mansourzadeh Phelps, RN
• Alan Frederick Philippi, D.O.
• Elspeth Laura Phillips, CRNA, DNP
• Phoenix Aspiration System of Care LLC
• Cynthia B. Piccirilli, M.D.
• Pieces to Peace LLC
• Desirae Nicole Pierce, NNP
• Ja'Lesa Pierce, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.