Active NPI
Loriann Samantha Demello, BCABA
- Assistant Behavior Analyst
- Lake Clarke Shores, FL
National Provider Identifier
1992182760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- 0-14-5945
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0145945 | FL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Behavior Analyst
- Cocoa, FL
- NPI 1205376902
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.