Active NPI
Vanessa Gilliam, M.ED., BCBA, LBA
- Behavior Analyst
- Dallas, TX
National Provider Identifier
1922483577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-49803
- Practice address
- 4235 Cedar Springs Rd
Dallas, TX 75219 - Phone
- (469) 906-6372
- NPI assigned
- Jul 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-49803 | TX | Primary |
Addresses
Primary practice location
4235 Cedar Springs Rd
Dallas, TX 75219
Mailing address
12941 North Freeway
Suite 750
Houston, TX 77060
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 Education
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650499200000",
"number": "1922483577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12941 NORTH FREEWAY",
"address_2": "SUITE 750",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4235 CEDAR SPRINGS RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "75219",
"telephone_number": "469-906-6372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "VANESSA",
"credential": "M.ED., BCBA, LBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-24",
"last_updated": "2022-04-21",
"certification_date": "2022-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "1-21-49803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.