NPI 1508724006 · live from the CMS NPI Registry
Michael Gennaco
Behavior Analyst in Portland, ME. National Provider Identifier 1508724006, active.
NPI record
| NPI | 1508724006 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 1250 Forest Ave Ste 301, Portland, ME 04103 |
| Practice phone | 888-477-3324 |
| Mailing address | 42 Destinee Ln Unit B, Naples, ME 04055 |
| Enumerated | January 13, 2026 |
| Last updated | January 13, 2026 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 1-24-74050 (ME) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.