NPIMap

Individual provider Active NPI

Mary Stevenson, M.ED

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1174066294
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BA-0251 Issued in AZ
Practice address
4530 E Muirwood Dr Ste 103
Phoenix, AZ 85048-7693
Phone
(480) 610-6981
Fax
(480) 898-7419
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BA-0251 AZ Primary

Addresses

Primary practice location

4530 E Muirwood Dr Ste 103
Phoenix, AZ 85048-7693

Mailing address

4530 E Muirwood Dr Ste 103
Phoenix, AZ 85048-7693
Phone (480) 610-6981

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
BA-0251AZMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Ally Pediatric Therapy LLC Behavior Analyst Past Accepting new patients
Soar Health, Inc. Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1174066294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487693",
            "telephone_number": "480-610-6981",
            "fax_number": "480-898-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487693",
            "telephone_number": "480-610-6981",
            "fax_number": "480-898-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "MARY",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BA-0251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.