Active NPI
Leslie Gooding, BACB740780
- Behavior Technician
- Fort Mill, SC
National Provider Identifier
1013615038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-199624
- Practice address
- 110 E Leroy St
Fort Mill, SC 29715-1808 - Phone
- (803) 322-8490
- NPI assigned
- Feb 20, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-22-199624 | SC | Primary |
Addresses
Primary practice location
110 E Leroy St
Fort Mill, SC 29715-1808
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Phone (855) 832-6727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106S00000X | Other | CIGNA SC |
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 |
|---|---|---|---|
| RBT-22-199624 | SC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1013615038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E LEROY ST",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297151808",
"telephone_number": "803-322-8490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODING",
"first_name": "LESLIE",
"credential": "BACB740780",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-20",
"last_updated": "2023-02-20",
"certification_date": "2023-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "SC",
"license": "RBT-22-199624",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA SC",
"identifier": "106S00000X",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Mill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.