Individual provider Active NPI

Danielle Philp

  • Behavior Analyst
  • Port Jefferson Station, NY
National Provider Identifier
1194127753
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
72 Champlain St
Port Jefferson Station, NY 11776-4449
Phone
(631) 356-4086
NPI assigned
Sep 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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 Primary

Addresses

Primary practice location

72 Champlain St
Port Jefferson Station, NY 11776-4449

Mailing address

72 Champlain St
Port Jefferson Station, NY 11776-4449
Phone (631) 356-4086

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": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1194127753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 CHAMPLAIN ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117764449",
            "telephone_number": "631-356-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 CHAMPLAIN ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117764449",
            "telephone_number": "631-356-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILP",
        "first_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.