Individual provider Active NPI

Myar Ebraheem

  • Behavior Technician
  • Greensboro, NC
National Provider Identifier
1003777558
Registry record updated Nov 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
24-390367
Practice address
7 Oak Branch Dr Ste E
Greensboro, NC 27407-2392
Phone
(888) 392-8642
NPI assigned
Nov 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 24-390367 Primary

Addresses

Primary practice location

7 Oak Branch Dr Ste E
Greensboro, NC 27407-2392

Mailing address

805 Chancy LN
Winston Salem, NC 27104-1254

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763769600000",
    "number": "1003777558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 CHANCY LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271041254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 OAK BRANCH DR STE E",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274072392",
            "telephone_number": "888-392-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHEEM",
        "first_name": "MYAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-22",
        "last_updated": "2025-11-22",
        "certification_date": "2025-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "24-390367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.