Jennifer Correll

Individual provider Active NPI Behavior Technician · Moyock, NC

NPI 1003419672 · NPPES record last updated Nov 17, 2020

Key facts

NPI
1003419672
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
108 Rocky Top Rd
Moyock, NC 27958-9284
Phone
(757) 769-9595
NPI assigned
Nov 17, 2020
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Helianthus Positive Behavior Supports LLC Past
since Nov 22, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

108 Rocky Top Rd
Moyock, NC 27958-9284

Mailing address

1912 Starling St Apt 209
Chesapeake, VA 23322-4389
Phone (757) 269-8162

Other practice location 1

1912 Starling St Apt 209
Chesapeake, VA 23322-4389
Phone (757) 269-8162

Other providers in Moyock, NC

All providers in Moyock, NC · Behavior Technician in North Carolina

Sources for this page

Verify at the official NPI Registry.