Melloney Santiago, QMHP

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3830 Washington Rd
Martinez, GA 30907-5064

Phone

(762) 222-7629

Fax

(615) 577-5654

NPI assigned

Dec 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1154866291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 MURFREESBORO PIKE STE 702",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372172679",
            "telephone_number": "844-359-7629",
            "fax_number": "615-577-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 WASHINGTON RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309075064",
            "telephone_number": "762-222-7629",
            "fax_number": "615-577-5654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Fairway Dr",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Deerfield Bch",
            "state": "FL",
            "postal_code": "334411814",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "MELLONEY",
        "credential": "QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-28",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Martinez, GA
• Providers in Martinez, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.