Active NPI
Amy J Barker-Deptuch, M.S., BCBA, LBA
- Behavior Analyst
- Manorville, NY
National Provider Identifier
1184873051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 000839
- Practice address
- 21 Fairway Dr
Manorville, NY 11949-2909 - Phone
- (516) 635-2292
- Fax
- (631) 909-2960
- NPI assigned
- Sep 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 759970 | NY | |
| Behavior Analyst | 103K00000X | 000839 | NY | Primary |
Addresses
Primary practice location
21 Fairway Dr
Manorville, NY 11949-2909
Mailing address
21 Fairway Dr
Manorville, NY 11949-2909
Phone (516) 635-2292
Other names 1
- Amy J Barker
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 759970 | NY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1184873051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 FAIRWAY DR",
"city": "MANORVILLE",
"state": "NY",
"postal_code": "119492909",
"telephone_number": "516-635-2292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 FAIRWAY DR",
"city": "MANORVILLE",
"state": "NY",
"postal_code": "119492909",
"telephone_number": "516-635-2292",
"fax_number": "631-909-2960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARKER-DEPTUCH",
"first_name": "AMY",
"middle_name": "J",
"credential": "M.S., BCBA, LBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "759970",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "000839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "BARKER",
"middle_name": "J",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Manorville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.