Active NPI
Crystal Lissuzzo, BCBA
- Behavior Analyst
- Edmond, OK
National Provider Identifier
1861844755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 16538 N May Ave
Edmond, OK 73012-9007 - Phone
- (405) 253-0071
- NPI assigned
- Jul 5, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
16538 N May Ave
Edmond, OK 73012-9007
Mailing address
16538 N May Ave
Edmond, OK 73012-9007
Phone (405) 253-0071
Other practice location 1
100 Congress Ave
Suite 2000
Austin, TX 78701-4072
Phone (888) 880-9720
Other practice location 2
17613 Hampton Park Dr Unit A
Edmond, OK 73012-0688
Phone (219) 242-2548
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopebridge LLC | Behavior Analyst | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1861844755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16538 N MAY AVE",
"city": "EDMOND",
"state": "OK",
"postal_code": "730129007",
"telephone_number": "405-253-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16538 N MAY AVE",
"city": "EDMOND",
"state": "OK",
"postal_code": "730129007",
"telephone_number": "405-253-0071"
}
],
"practiceLocations": [
{
"address_1": "100 Congress Ave",
"address_2": "Suite 2000",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787014072",
"country_code": "US",
"telephone_number": "888-880-9720",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "17613 Hampton Park Dr Unit A",
"address_purpose": "LOCATION",
"city": "Edmond",
"state": "OK",
"postal_code": "730120688",
"country_code": "US",
"telephone_number": "219-242-2548",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LISSUZZO",
"first_name": "CRYSTAL",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-05",
"last_updated": "2021-08-18",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.