Individual provider Active NPI

Alicia Marie Flora Roberts, BS

  • Behavior Technician
  • Cary, NC
National Provider Identifier
1053152322
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
000048725158 Issued in NC
Practice address
111 Mackenan Dr
Cary, NC 27511-7903
Phone
(919) 371-2848
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X 000048725158 NC Primary

Addresses

Primary practice location

111 Mackenan Dr
Cary, NC 27511-7903

Mailing address

11 Nadeau CT
Durham, NC 27704-5157
Phone (919) 622-7992

Other names 1

  • Alicia Marie Flor Roberts Former name

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
000048725158NCMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1053152322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NADEAU CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277045157",
            "telephone_number": "919-622-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MACKENAN DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275117903",
            "telephone_number": "919-371-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ALICIA",
        "middle_name": "MARIE FLORA",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "000048725158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "ROBERTS",
            "middle_name": "MARIE FLOR",
            "credential": "BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.

Verify at the official NPI Registry.