Leah Christine Gongola, PH.D., BCBA-D

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-09-5195 Issued in OH

Practice address

15445 Chardon Windsor Rd
Huntsburg, OH 44046-8728

Phone

(440) 313-8636

NPI assigned

Jul 31, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Proactive Behavior Therapy

  • Behavior Technician
  • Chesterland, OH
  • NPI 1912686197

  Behavior Analyst

  NPD Authorized official
• Proactive Behavior Therapy, LLC

  • Community/Behavioral Health Agency
  • Chesterland, OH
  • NPI 1184275117

  Behavior Analyst

  NPD Authorized official

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

{
    "created_epoch": "1280534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280534400000",
    "number": "1851605901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15445 CHARDON WINDSOR RD",
            "city": "HUNTSBURG",
            "state": "OH",
            "postal_code": "440468728",
            "telephone_number": "440-313-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15445 CHARDON WINDSOR RD",
            "city": "HUNTSBURG",
            "state": "OH",
            "postal_code": "440468728",
            "telephone_number": "440-313-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONGOLA",
        "first_name": "LEAH",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PH.D., BCBA-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-31",
        "last_updated": "2010-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OH",
            "license": "1-09-5195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Huntsburg, OH
• Behavior Analyst in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2010; 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.