Active NPI
Elizabeth Coronado, BCBA
- Behavior Analyst
- Brentwood, TN
National Provider Identifier
1891325973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 572
- Practice address
- 9005 Overlook Blvd PMB#637
Brentwood, TN 37027-5269 - Phone
- (615) 570-9959
- Fax
- (646) 859-4440
- NPI assigned
- Jan 17, 2020
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 572 | TN | Primary |
| Behavior Technician | 106S00000X | RBT-18-50880 | TN |
Addresses
Primary practice location
9005 Overlook Blvd PMB#637
Brentwood, TN 37027-5269
Mailing address
9005 Overlook Blvd PMB#637
Brentwood, TN 37027-5269
Phone (615) 570-9959
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 |
|---|---|---|---|
| RBT-18-50880 | TN | MD | Behavior Technician |
| 572 | TN | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Junior Boom ABA 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.
-
- Behavior Analyst
- Brooklyn, NY
- NPI 1861194490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579219200000",
"number": "1891325973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9005 OVERLOOK BLVD PMB#637",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275269",
"telephone_number": "615-570-9959",
"fax_number": "646-859-4440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9005 OVERLOOK BLVD PMB#637",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275269",
"telephone_number": "615-570-9959",
"fax_number": "646-859-4440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORONADO",
"first_name": "ELIZABETH",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2020-01-17",
"certification_date": "2020-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TN",
"license": "572",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TN",
"license": "RBT-18-50880",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.