Active NPI
Mary Fanelli
- Behavior Analyst
- Orwigsburg, PA
National Provider Identifier
1861807232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BH001769
- Practice address
- 340 S Liberty St
Orwigsburg, PA 17961-2127 - Phone
- (570) 366-1154
- Fax
- (570) 366-7711
- NPI assigned
- Jun 24, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BH001769 | PA | Primary |
Addresses
Primary practice location
340 S Liberty St
Orwigsburg, PA 17961-2127
Mailing address
401 S Margaretta St
Schuylkill Haven, PA 17972-1709
Phone (570) 449-1869
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH001769 | PA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Services Inc. | Past | 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 and National Provider Directory roles.
-
- Public Health or Welfare Agency
- Orwigsburg, PA
- NPI 1760503981
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403654400000",
"number": "1861807232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S MARGARETTA ST",
"city": "SCHUYLKILL HAVEN",
"state": "PA",
"postal_code": "179721709",
"telephone_number": "570-449-1869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 S LIBERTY ST",
"city": "ORWIGSBURG",
"state": "PA",
"postal_code": "179612127",
"telephone_number": "570-366-1154",
"fax_number": "570-366-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANELLI",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-24",
"last_updated": "2014-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "BH001769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orwigsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.