Active NPI
Cassidy Nicole McMullen
- Behavior Technician
- New Port Richey, FL
National Provider Identifier
1154032159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 22-215611
- Practice address
- 6533 River Rd
New Port Richey, FL 34652-2229 - Phone
- (678) 382-4103
- NPI assigned
- Dec 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 22-215611 | GA | Primary |
Addresses
Primary practice location
6533 River Rd
New Port Richey, FL 34652-2229
Mailing address
2254 Coachman Rd
Spring Hill, FL 34608-5245
Phone (678) 382-4103
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 |
|---|---|---|---|
| 22-215611 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709942400000",
"number": "1154032159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2254 COACHMAN RD",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346085245",
"telephone_number": "678-382-4103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6533 RIVER RD",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346522229",
"telephone_number": "678-382-4103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMULLEN",
"first_name": "CASSIDY",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-09",
"last_updated": "2024-03-09",
"certification_date": "2024-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "22-215611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Port Richey, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.