Elizabeth Pettit

Key facts

NPI

1154722973

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

Practice address

9601 339TH St S
Roy, WA 98580-9480

Phone

(360) 628-0993

NPI assigned

Sep 11, 2014

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Behavior Connections LLC Behavior Analyst · Roy, WA · NPI 1396405296
  NPD Authorized official BEHAVIOR ANALYST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 5, 2022.

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1154722973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 339TH ST S",
            "city": "ROY",
            "state": "WA",
            "postal_code": "985809480",
            "telephone_number": "360-628-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 339TH ST S",
            "city": "ROY",
            "state": "WA",
            "postal_code": "985809480",
            "telephone_number": "360-628-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Roy, WA · Behavior Analyst in Washington