Individual provider Active NPI

Emily R Mozingo, MA, BCBA, LBA

  • Behavior Analyst
  • North Chesterfield, VA
National Provider Identifier
1912540048
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0133003386 Issued in VA
Practice address
2500 Pocoshock PL Ste 102
North Chesterfield, VA 23235-6345
Phone
(804) 562-8705
NPI assigned
Oct 22, 2019
Last updated
Dec 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Analyst 103K00000X 0133003386 VA Primary
Assistant Behavior Analyst 106E00000X VA

Addresses

Primary practice location

2500 Pocoshock PL Ste 102
North Chesterfield, VA 23235-6345

Mailing address

4313 Tracker Dr
Chesterfield, VA 23832-7915
Phone (804) 436-4161

Other identifiers 1

IdentifierTypeStateIssuer
110026265EMedicaidMA

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0133003386VAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
T & E Management Behavior Analyst PastSince Sep 5, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1912540048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 TRACKER DR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238327915",
            "telephone_number": "804-436-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 POCOSHOCK PL STE 102",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232356345",
            "telephone_number": "804-562-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZINGO",
        "first_name": "EMILY",
        "middle_name": "R",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133003386",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026265E",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.