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General NPI Number Information
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NPI Number | 1841066743
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Entity Type | Individual
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Provider Name | LEWIS A MAZZONE JR. MA, SSP, BCBA, NCSP
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Gender | Male
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 4823 ROLLING GREEN DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-7044
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Country | US
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Telephone | 516-395-7543
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Fax |
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Provider Business Mailing Address
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Address Line | 4823 ROLLING GREEN DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-7044
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Country | US
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Telephone | 516-395-7543
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS1897
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License Number State | FL
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