Active NPI
Courtney Lenorea Mickelson Mongeon
- Behavior Technician
- Scottsdale, AZ
National Provider Identifier
1033677356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 8130 E Cactus Rd Ste 510
Scottsdale, AZ 85260-5263 - Phone
- (480) 322-6342
- NPI assigned
- Mar 5, 2019
- 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 | Primary |
Addresses
Primary practice location
8130 E Cactus Rd Ste 510
Scottsdale, AZ 85260-5263
Mailing address
20808 N 27TH Ave Apt 1233
Phoenix, AZ 85027-3234
Phone (608) 799-5464
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": "1551744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551744000000",
"number": "1033677356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20808 N 27TH AVE APT 1233",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850273234",
"telephone_number": "608-799-5464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8130 E CACTUS RD STE 510",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852605263",
"telephone_number": "480-322-6342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKELSON MONGEON",
"first_name": "COURTNEY",
"middle_name": "LENOREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-05",
"last_updated": "2019-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.