Megan Brooke Agris, M.S., BCBA

Key facts

NPI

1154736148

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

License

11415180 (NC)

Practice address

4900 Waters Edge Dr Ste 100
Raleigh, NC 27606-5662

Phone

(919) 219-6625

NPI assigned

Jun 27, 2014

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 3, 2021.

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1154736148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8413 ASHWOOD DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276039310",
            "telephone_number": "919-219-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 WATERS EDGE DR STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276065662",
            "telephone_number": "919-219-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRIS",
        "first_name": "MEGAN",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "11415180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Raleigh, NC · Behavior Analyst in North Carolina