Individual provider Active NPI

Deven Renae Vantrease, BCBA, LBA

  • Behavior Analyst
  • Inwood, NY
National Provider Identifier
1871121202
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12369331 Issued in FL
Practice address
159 Doughty Blvd
Inwood, NY 11096
Phone
(317) 886-8900
NPI assigned
Mar 31, 2020
Last updated
May 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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 12369331 FL Primary

Addresses

Primary practice location

159 Doughty Blvd
Inwood, NY 11096

Mailing address

6602 Boat Race Rd
Panama City, FL 32404-9616
Phone (850) 890-3936

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
12369331FLMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1871121202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6602 BOAT RACE RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324049616",
            "telephone_number": "850-890-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 DOUGHTY BLVD",
            "city": "INWOOD",
            "state": "NY",
            "postal_code": "11096",
            "telephone_number": "317-886-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTREASE",
        "first_name": "DEVEN",
        "middle_name": "RENAE",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "12369331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.