Active NPI
Madalyn Clontz
- Behavior Technician
- Stanfield, NC
National Provider Identifier
1164003174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 7778 Bertha LN
Stanfield, NC 28163-9605 - Phone
- (704) 776-0385
- NPI assigned
- Apr 20, 2021
- Last updated
- Apr 20, 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
7778 Bertha LN
Stanfield, NC 28163-9605
Mailing address
7778 Bertha LN
Stanfield, NC 28163-9605
Phone (704) 776-0385
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0 | Other | 0 |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1164003174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7778 BERTHA LN",
"city": "STANFIELD",
"state": "NC",
"postal_code": "281639605",
"telephone_number": "704-776-0385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7778 BERTHA LN",
"city": "STANFIELD",
"state": "NC",
"postal_code": "281639605",
"telephone_number": "704-776-0385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLONTZ",
"first_name": "MADALYN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanfield, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.