Individual provider Active NPI

Amanda Duffy, M.ED.,BCBA

  • Behavior Analyst
  • Newtown Square, PA
National Provider Identifier
1174988059
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-12-12537 Issued in PA
Practice address
140 Rockwood Rd
Newtown Square, PA 19073-4268
Phone
(610) 688-8597
Fax
(610) 688-8632
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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 1-12-12537 PA Primary

Addresses

Primary practice location

140 Rockwood Rd
Newtown Square, PA 19073-4268

Mailing address

140 Rockwood Rd
Newtown Square, PA 19073-4268
Phone (610) 688-8597

Other identifiers 1

IdentifierTypeStateIssuer
1-12-12537OtherPABEHAVIOR ANALYST CERTIFICATION BOARD

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

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1174988059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ROCKWOOD RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190734268",
            "telephone_number": "610-688-8597",
            "fax_number": "610-688-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ROCKWOOD RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190734268",
            "telephone_number": "610-688-8597",
            "fax_number": "610-688-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "AMANDA",
        "credential": "M.ED.,BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "1-12-12537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "1-12-12537",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.