Individual provider Active NPI

Crystal Marie Wissinger, BCBA

  • Behavior Analyst
  • Laurel, MD
National Provider Identifier
1124399662
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-11-8182 Issued in MD
Practice address
8344 Mary Lee LN
Laurel, MD 20723-1192
Phone
(512) 299-3371
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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 1-11-8182 MD Primary

Addresses

Primary practice location

8344 Mary Lee LN
Laurel, MD 20723-1192

Mailing address

8344 Mary Lee LN
Laurel, MD 20723-1192
Phone (512) 299-3371

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": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1124399662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8344 MARY LEE LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231192",
            "telephone_number": "512-299-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8344 MARY LEE LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231192",
            "telephone_number": "512-299-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSINGER",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "1-11-8182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.