Active NPI
Deborah Holan, RBT
- Behavior Technician
- West Boylston, MA
National Provider Identifier
1043052301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-293275
- Practice address
- 216 W Boylston St Ste 200
West Boylston, MA 01583-1788 - Phone
- (508) 213-3355
- NPI assigned
- Jun 8, 2024
- Sex
- Female
- Sole proprietor
- Yes
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-23-293275 | MA | Primary |
Addresses
Primary practice location
216 W Boylston St Ste 200
West Boylston, MA 01583-1788
Mailing address
53 Reed St
Worcester, MA 01602-4364
Phone (508) 769-6189
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-23-293275 | MA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FBTC Transitional Sub, LLC | Current | Accepting new patients |
Locations
216 W Boylston St
Ste 200
West Boylston, MA 01583
Phone (508) 213-3355
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.
-
- Community/Behavioral Health Agency
- Beverly, MA
- NPI 1881283091
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717804800000",
"number": "1043052301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 REED ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016024364",
"telephone_number": "508-769-6189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 W BOYLSTON ST STE 200",
"city": "WEST BOYLSTON",
"state": "MA",
"postal_code": "015831788",
"telephone_number": "508-213-3355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLAN",
"first_name": "DEBORAH",
"name_prefix": "Ms.",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-08",
"last_updated": "2024-06-08",
"certification_date": "2024-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": "RBT-23-293275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Boylston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.