Active NPI
Danielle Wolak
- Assistant Behavior Analyst
- Wasilla, AK
National Provider Identifier
1003287673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- 8954
- Practice address
- 4272 Timberland Loop
Wasilla, AK 99654 - Phone
- (907) 521-0890
- NPI assigned
- Oct 8, 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | RBT-15-05218 | MS | |
| Assistant Behavior Analyst | 106E00000X | 8954 | AK | Primary |
Addresses
Primary practice location
4272 Timberland Loop
Wasilla, AK 99654
Mailing address
4272 Timberland Loop
Wasilla, AK 99654
Other practice location 1
146 S Thomas St
Tupelo, MS 38801-5328
Phone (662) 840-0974
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 |
|---|---|---|---|
| 8954 | AK | MD | Assistant Behavior Analyst |
| RBT-15-05218 | MS | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1003287673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4272 TIMBERLAND LOOP",
"city": "WASILLA",
"state": "AK",
"postal_code": "99654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4272 TIMBERLAND LOOP",
"city": "WASILLA",
"state": "AK",
"postal_code": "99654",
"telephone_number": "907-521-0890"
}
],
"practiceLocations": [
{
"address_1": "146 S Thomas St",
"address_purpose": "LOCATION",
"city": "Tupelo",
"state": "MS",
"postal_code": "388015328",
"country_code": "US",
"telephone_number": "662-840-0974",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLAK",
"first_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-08",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "MS",
"license": "RBT-15-05218",
"primary": false
},
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "AK",
"license": "8954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.