NPIMap

Organization Active NPI

Magnolia Behavior Therapy

  • Behavior Analyst
  • Seattle, WA
National Provider Identifier
1033583372
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
CG60618517 Issued in WA
Legal business name
MAGNOLIA BEHAVIOR THERAPY
Practice address
3214 W McGraw St
Suite 212
Seattle, WA 98199-3239
Phone
(206) 453-4882
NPI assigned
Nov 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Authorized official

Name
McCullough Campbell
Title
Administator
Phone
(206) 453-4882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X CG60618517 WA Primary

Addresses

Primary practice location

3214 W McGraw St
Suite 212
Seattle, WA 98199-3239

Mailing address

3214 W McGraw St
Suite 212
Seattle, WA 98199-3239
Phone (206) 453-4882

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1033583372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3214 W MCGRAW ST",
            "address_2": "SUITE 212",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993239",
            "telephone_number": "206-453-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 W MCGRAW ST",
            "address_2": "SUITE 212",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993239",
            "telephone_number": "206-453-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA BEHAVIOR THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "MCCULLOUGH",
        "authorized_official_title_or_position": "ADMINISTATOR",
        "authorized_official_telephone_number": "206-453-4882"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "CG60618517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.