Individual provider Active NPI

Lisa Ferrentino, BCBA

  • Behavior Analyst
  • Shelton, CT
National Provider Identifier
1861985681
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1295 Issued in CT
Practice address
1000 Bridgeport Ave Ste 402
Shelton, CT 06484-4669
Phone
(203) 494-3444
NPI assigned
Jun 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1295 CT Primary

Addresses

Primary practice location

1000 Bridgeport Ave Ste 402
Shelton, CT 06484-4669

Mailing address

14 Mott St
Ansonia, CT 06401-1930
Phone (203) 494-3444

Other practice location 1

14 Mott St
Ansonia, CT 06401-1930
Phone (203) 494-3444

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

LicenseStateTypeSpecialty
1295CTMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Next Step ABA Therapy Behavior Analyst CurrentSince Dec 12, 2021 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": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1861985681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MOTT ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064011930",
            "telephone_number": "203-494-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRIDGEPORT AVE STE 402",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844669",
            "telephone_number": "203-494-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Mott St",
            "address_purpose": "LOCATION",
            "city": "Ansonia",
            "state": "CT",
            "postal_code": "064011930",
            "country_code": "US",
            "telephone_number": "203-494-3444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERRENTINO",
        "first_name": "LISA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "1295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.

Verify at the official NPI Registry.