Active NPI
Jana Barbara Mallis, LBS
- Behavior Analyst
- Cheltenham, PA
National Provider Identifier
1992119754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BH000549
- Practice address
- 53 Dewey Rd
Cheltenham, PA 19012-1413 - Phone
- (215) 635-1110
- Fax
- (215) 635-5224
- NPI assigned
- Jun 19, 2014
- 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 | BH000549 | PA | Primary |
Addresses
Primary practice location
53 Dewey Rd
Cheltenham, PA 19012-1413
Mailing address
53 Dewey Rd
Cheltenham, PA 19012-1413
Phone (215) 635-1110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BH000549 | Other | PA | COMMONWEALTH OF PA, DEPT OF STATE, BUREAU OF PROFESSIONAL & OCCUPATIONAL AFFAIRS |
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 |
|---|---|---|---|
| BH000549 | PA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403136000000",
"number": "1992119754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 DEWEY RD",
"city": "CHELTENHAM",
"state": "PA",
"postal_code": "190121413",
"telephone_number": "215-635-1110",
"fax_number": "215-635-5224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 DEWEY RD",
"city": "CHELTENHAM",
"state": "PA",
"postal_code": "190121413",
"telephone_number": "215-635-1110",
"fax_number": "215-635-5224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLIS",
"first_name": "JANA",
"middle_name": "BARBARA",
"name_prefix": "Dr.",
"credential": "LBS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-19",
"last_updated": "2014-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "BH000549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMONWEALTH OF PA, DEPT OF STATE, BUREAU OF PROFESSIONAL & OCCUPATIONAL AFFAIRS",
"identifier": "BH000549",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cheltenham, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.