Individual provider Active NPI

Julia Mlynarick

  • Behavior Analyst
  • Indian Trail, NC
National Provider Identifier
1124627559
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-25-80659 Issued in IN
Practice address
6098 W Hwy 74
Indian Trail, NC 28079
Phone
(980) 375-6585
Fax
(317) 520-8200
NPI assigned
Oct 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Analyst 103K00000X 1-25-80659 IN Primary

Addresses

Primary practice location

6098 W Hwy 74
Indian Trail, NC 28079

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other practice location 1

5819 Parkstone Dr
Matthews, NC 28104-0563
Phone (315) 601-0980

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

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Society of North Carolina, Inc. PastSince Oct 1, 2020 Accepting new patients
Hopebridge LLC 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": "1602892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1124627559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6098 W HWY 74",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "28079",
            "telephone_number": "980-375-6585",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5819 Parkstone Dr",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281040563",
            "country_code": "US",
            "telephone_number": "315-601-0980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MLYNARICK",
        "first_name": "JULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-17",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-25-80659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.