Active NPI
Molly Eagle
- Behavior Technician
- Leavenworth, KS
National Provider Identifier
1174239131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 23-255189
- Practice address
- 1719 Metropolitan Ave
Leavenworth, KS 66048-1124 - Phone
- (913) 250-5634
- NPI assigned
- Jan 24, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 23-255189 | KS | Primary |
Addresses
Primary practice location
1719 Metropolitan Ave
Leavenworth, KS 66048-1124
Mailing address
5863 NW 72ND St
Kansas City, MO 64151-1483
Phone (816) 984-8280
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23-255189 | KS | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family First Center for Autism and Child Development, Inc. | Past | Accepting new patients |
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.
-
- Clinical Child & Adolescent Psychologist
- Kansas City, MO
- NPI 1154626893
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674518400000",
"number": "1174239131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5863 NW 72ND ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641511483",
"telephone_number": "816-984-8280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1719 METROPOLITAN AVE",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660481124",
"telephone_number": "913-250-5634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGLE",
"first_name": "MOLLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-24",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "KS",
"license": "23-255189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leavenworth, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.