Individual provider Active NPI

Loriann Samantha Demello, BCABA

  • Assistant Behavior Analyst
  • Lake Clarke Shores, FL
National Provider Identifier
1992182760
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-14-5945 Issued in FL
Practice address
1815 Forest Hill Blvd
Lake Clarke Shores, FL 33406
Phone
(561) 360-3169
NPI assigned
Apr 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0145945 FL
Assistant Behavior Analyst 106E00000X 0-14-5945 FL Primary

Addresses

Primary practice location

1815 Forest Hill Blvd
Lake Clarke Shores, FL 33406

Mailing address

1815 Forest Hill Blvd
Lake Clarke Shores, FL 33406-6021
Phone (561) 360-3169

Other practice location 1

4026 Wilkes Dr
Melbourne, FL 32901-8487
Phone (321) 405-7252

Other practice location 2

2073 Garden St
Titusville, FL 32796-3243
Phone (321) 888-3020

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
0145945FLMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Able Academics, LLC Behavior Analyst Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1992182760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 FOREST HILL BLVD",
            "city": "LAKE CLARKE SHORES",
            "state": "FL",
            "postal_code": "334066021",
            "telephone_number": "561-360-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 FOREST HILL BLVD",
            "city": "LAKE CLARKE SHORES",
            "state": "FL",
            "postal_code": "33406",
            "telephone_number": "561-360-3169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4026 Wilkes Dr",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329018487",
            "country_code": "US",
            "telephone_number": "321-405-7252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2073 Garden St",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "327963243",
            "country_code": "US",
            "telephone_number": "321-888-3020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMELLO",
        "first_name": "LORIANN",
        "middle_name": "SAMANTHA",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "0145945",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-14-5945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Clarke Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.