Active NPI
Ivy Doulin
- Behavior Technician
- Harriman, NY
National Provider Identifier
1063180511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-180538
- Practice address
- 118 River Rd Ste 14
Harriman, NY 10926-3040 - Phone
- (520) 884-5863
- NPI assigned
- Aug 31, 2021
- Last updated
- Aug 31, 2021
- 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-21-180538 | NY | Primary |
Addresses
Primary practice location
118 River Rd Ste 14
Harriman, NY 10926-3040
Mailing address
PO Box 760
Cornwall, NY 12518-0760
Phone (845) 275-2541
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-21-180538 | NY | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1063180511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 760",
"city": "CORNWALL",
"state": "NY",
"postal_code": "125180760",
"telephone_number": "845-275-2541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 RIVER RD STE 14",
"city": "HARRIMAN",
"state": "NY",
"postal_code": "109263040",
"telephone_number": "520-884-5863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOULIN",
"first_name": "IVY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-31",
"last_updated": "2021-08-31",
"certification_date": "2021-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NY",
"license": "RBT-21-180538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harriman, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.