Individual provider Active NPI

Matthew Delaney, BCBA

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1932489655
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
45 Alabama Ave
Jacksonville, FL 32218-2677
Phone
(904) 420-2304
Fax
(904) 508-0173
NPI assigned
Aug 25, 2011
Last updated
Oct 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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 Primary

Addresses

Primary practice location

45 Alabama Ave
Jacksonville, FL 32218-2677

Mailing address

300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (407) 915-7729

Other practice location 1

6867 Southpoint Dr N
Jacksonville, FL 32216-8043
Phone (904) 619-6071

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mandala Family Wellness LLC Current Accepting new patients
Mandala Family Wellness LLC Current Accepting new patients

Organizations & group practices 2

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": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1932489655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 200",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465028",
            "telephone_number": "407-915-7729",
            "fax_number": "407-588-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ALABAMA AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182677",
            "telephone_number": "904-420-2304",
            "fax_number": "904-508-0173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6867 Southpoint Dr N",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322168043",
            "country_code": "US",
            "telephone_number": "904-619-6071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELANEY",
        "first_name": "MATTHEW",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-25",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.