Active NPI
Stacey Cohen
- Behavior Technician
- Frederick, MD
National Provider Identifier
1104560192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 5300 Westview Dr
Frederick, MD 21703-8339 - Phone
- (240) 242-5865
- NPI assigned
- Apr 25, 2022
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
5300 Westview Dr
Frederick, MD 21703-8339
Mailing address
5300 Westview Dr
Frederick, MD 21703-8339
Phone (240) 242-5865
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21701 | Medicaid | MD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650844800000",
"number": "1104560192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 WESTVIEW DR",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217038339",
"telephone_number": "240-242-5865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 WESTVIEW DR",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217038339",
"telephone_number": "240-242-5865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "STACEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-25",
"last_updated": "2022-04-25",
"certification_date": "2022-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "21701",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.