Individual provider Active NPI

Azucena Molly Tapia-Crisanto

  • Behavior Analyst
  • Baltimore, MD
National Provider Identifier
1083195812
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA1114 Issued in MD
Practice address
400 E Pratt St FL 8
Baltimore, MD 21202-3180
Phone
(833) 599-2560
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA1114 MD Primary

Addresses

Primary practice location

400 E Pratt St FL 8
Baltimore, MD 21202-3180

Mailing address

1016 Kathryn Rd
Silver Spring, MD 20904-2170

Other practice location 1

10411 Motor City Dr Ste 750
Bethesda, MD 20817-1289
Phone (888) 805-0759

Other practice location 2

5268 Nicholson Ln Ste G
Kensington, MD 20895-1010
Phone (703) 636-1703

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

LicenseStateTypeSpecialty
LBA1114MDMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1083195812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 KATHRYN RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E PRATT ST FL 8",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023180",
            "telephone_number": "833-599-2560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10411 Motor City Dr Ste 750",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208171289",
            "country_code": "US",
            "telephone_number": "888-805-0759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5268 Nicholson Ln Ste G",
            "address_purpose": "LOCATION",
            "city": "Kensington",
            "state": "MD",
            "postal_code": "208951010",
            "country_code": "US",
            "telephone_number": "703-636-1703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAPIA-CRISANTO",
        "first_name": "AZUCENA",
        "middle_name": "MOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "LBA1114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.