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Deactivated NPI 1669619573 Deactivated / Inactive NPI Female Practitioner

Dr. Lisa Anna Spano , PsyD, BCBA-D

Behavior Analyst • Somerset, NJ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Lisa Spano has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 14, 2009
NPI Deactivation Date July 20, 2011
Total Practice Duration ~2 Years of Practice (2009 – 2011)

Professional Overview & Biography Verified Profile Summary

Dr. Lisa Spano, PsyD, BCBA-D was a registered Behavior Analyst practicing in Somerset, NJ. Throughout an active medical career spanning 2 years, Dr. Spano provided care at the practice location at 35 CLYDE RD until profile deactivation on 2011-07-20.

Practice Location & Contact Primary Location

Practice Address

35 Clyde Rd
Suite 101

Somerset, NJ 088735033

Telephone 7328731212
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Somerset, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.8 Yrs
Regional Practice Density
36 Specialists

Practicing in Somerset, NJ (3790 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-06-15
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License NJ 1-05-2397

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Psychologist - Clinical

NUCC Taxonomy Code: 103TC0700X

State License NJ 083-957

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Dr. Mark Cooperberg , PhD

Psychologist - Clinical

NPI 1053443549

Doctor of Philosophy (Ph.D.)

Jeniffer Cruz

Psychologist

NPI 1124686852
Dr. Michael Selbst , PhD

Psychologist - School

NPI 1134251259

Doctor of Philosophy (Ph.D.)

NPI 1427771344

Board Certified Behavior Analyst - Doctoral, Doctor of Philosophy (Ph.D.)

NPI 1447690342

Doctor of Psychology (Psy.D.)

Dr. Debra Salzman , PhD

Psychologist - Clinical

NPI 1558536250

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
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Updated Business Mailing Address June 15, 2021

Registered at 15 GATES PLACE, WAYNE, NJ 07470 (Tel: 2016944998)

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Provider Name / Credentials Updated June 15, 2021

Recorded as LISA SPANO, PSY.D., BCBA-D

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2021

Psychologist (License #083-957 in NJ)

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Updated Practice Location June 10, 2021

Registered at 35 CLYDE RD, SUITE 101, SOMERSET, NJ 088735033 (Tel: 7328731212)

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Updated Business Mailing Address June 10, 2021

Registered at 233 MIDLAND AVE, #209, GARFIELD, NJ 070261737 (Tel: 2016944998)

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Provider Name / Credentials Updated June 10, 2021

Recorded as ELISABETTA PESTRICHELLA, PSY.D., BCBA

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 10, 2021

Behavior Analyst (License #1-05-2397 in NJ)

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NPI Profile Deactivated July 20, 2011

Record deactivated on July 20, 2011

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Initial NPI Registration & Enumeration January 14, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1669619573
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 14, 2009
Last Update: June 15, 2021
Deactivation Date: July 20, 2011
Sole Proprietor: Yes

Mailing Address

15 Gates Place

Wayne, NJ 07470

Phone: 2016944998

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.