Active NPI
Mariah Bermejo
- Behavior Technician
- Keller, TX
National Provider Identifier
1144851940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-59615
- Practice address
- 1901 S Main St
Keller, TX 76248-5120 - Phone
- (817) 691-3283
- NPI assigned
- Jan 30, 2020
- Last updated
- Jun 25, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | RBT1856915 | TX | |
| Behavior Technician | 106S00000X | RBT-18-59615 | TX | Primary |
Addresses
Primary practice location
1901 S Main St
Keller, TX 76248-5120
Mailing address
1901 S Main St
Keller, TX 76248-5120
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT1856915 | TX | MD | Behavioral Analyst |
| RBT-18-59615 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624579200000",
"number": "1144851940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 S MAIN ST",
"city": "KELLER",
"state": "TX",
"postal_code": "762485120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 S MAIN ST",
"city": "KELLER",
"state": "TX",
"postal_code": "762485120",
"telephone_number": "817-691-3283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERMEJO",
"first_name": "MARIAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-30",
"last_updated": "2021-06-25",
"certification_date": "2021-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "RBT1856915",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT-18-59615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keller, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.