Active NPI
Mariela Petraki
- Behavior Analyst
- Port Saint Lucie, FL
National Provider Identifier
1871080580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-56186
- Practice address
- 10701 SW Gloriana St
Port Saint Lucie, FL 34987-4706 - Phone
- (305) 709-8974
- NPI assigned
- Apr 18, 2018
- Last updated
- Sep 26, 2024
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-56186 | FL | Primary |
| Assistant Behavior Analyst | 106E00000X | 0-20-11301 | FL | |
| Behavior Technician | 106S00000X | NU |
Addresses
Primary practice location
10701 SW Gloriana St
Port Saint Lucie, FL 34987-4706
Mailing address
10701 SW Gloriana St
Port Saint Lucie, FL 34987-4706
Phone (305) 709-8974
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 |
|---|---|---|---|
| Agapula Corp | Behavior Analyst | Current | Accepting new patients |
| ABA Autism Therapies LLC | Behavior Analyst | Current | Accepting new patients |
| Foundart Inc. | Behavior Analyst | Past | Accepting new patients |
| Art of Behavior Analysis, Inc. | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Analyst
- West Palm Beach, FL
- NPI 1730889585
-
- Behavior Analyst
- West Palm Beach, FL
- NPI 1639918840
-
- Behavior Analyst
- Doral, FL
- NPI 1720631195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727308800000",
"number": "1871080580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10701 SW GLORIANA ST",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349874706",
"telephone_number": "305-709-8974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10701 SW GLORIANA ST",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349874706",
"telephone_number": "305-709-8974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRAKI",
"first_name": "MARIELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-18",
"last_updated": "2024-09-26",
"certification_date": "2024-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-21-56186",
"primary": true
},
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "FL",
"license": "0-20-11301",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.