NPIMap

Individual provider Active NPI

Stephanie Whittington, BCBA, LBA

  • Behavior Analyst
  • O Fallon, MO
National Provider Identifier
1104164094
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2012040955 Issued in MO
Practice address
105 Sheriff Dierker CT
O Fallon, MO 63366-2468
Phone
(636) 978-7785
Fax
(636) 978-7885
NPI assigned
Jan 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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 2012040955 MO Primary

Addresses

Primary practice location

105 Sheriff Dierker CT
O Fallon, MO 63366-2468

Mailing address

105 Sheriff Dierker CT
O Fallon, MO 63366-2468
Phone (636) 978-7785

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
2012040955MOMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Autism Education Past Accepting new patients
The Center for Autism Education Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1104164094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SHERIFF DIERKER CT",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662468",
            "telephone_number": "636-978-7785",
            "fax_number": "636-978-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SHERIFF DIERKER CT",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662468",
            "telephone_number": "636-978-7785",
            "fax_number": "636-978-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTINGTON",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2012040955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.