Individual provider Active NPI

Daniel Banaitis, LMFT

  • Behavior Analyst
  • Los Angeles, CA
National Provider Identifier
1932233954
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
12100 Wilshire Blvd Ste 800
Los Angeles, CA 90025-7140
Phone
(310) 775-1521
Fax
(424) 238-8694
NPI assigned
Mar 14, 2007
Last updated
Nov 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CA
Marriage & Family Therapist 106H00000X MFC44732 CA
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

12100 Wilshire Blvd Ste 800
Los Angeles, CA 90025-7140

Mailing address

2001 Olympic Blvd Apt 141
Santa Monica, CA 90404-3958
Phone (310) 775-1521

Other identifiers 4

IdentifierTypeStateIssuer
1346520459OtherBILLING NPI
495555OtherMHN
600719446OtherMAGELLAN GROUP MIS
600726290OtherMAGELLAN

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
MFC44732CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Banaitis Inc. Behavior Analyst Current Accepting new patients

Locations

11500 W Olympic Blvd
Ste 400
Los Angeles, CA 90064
Phone (310) 595-5984

12100 Wilshire Blvd
Ste 800
Los Angeles, CA 90025
Phone (310) 383-6610

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1932233954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 OLYMPIC BLVD APT 141",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904043958",
            "telephone_number": "310-775-1521",
            "fax_number": "424-238-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 WILSHIRE BLVD STE 800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257140",
            "telephone_number": "310-775-1521",
            "fax_number": "424-238-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAITIS",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC44732",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BILLING NPI",
            "identifier": "1346520459",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "495555",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN GROUP MIS",
            "identifier": "600719446",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "600726290",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.

Verify at the official NPI Registry.