Individual provider Active NPI

Alice Mutoni

  • Behavior Analyst
  • Winston Salem, NC
National Provider Identifier
1194616227
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
3059 Zacharys Keep CT
Winston Salem, NC 27103-6755
Phone
(336) 905-4971
NPI assigned
Jul 15, 2025
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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 NU Primary

Addresses

Primary practice location

3059 Zacharys Keep CT
Winston Salem, NC 27103-6755

Mailing address

3059 Zacharys Keep CT
Winston Salem, NC 27103-6755
Phone (336) 905-4971

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": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1194616227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3059 ZACHARYS KEEP CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036755",
            "telephone_number": "336-905-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 ZACHARYS KEEP CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036755",
            "telephone_number": "336-905-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTONI",
        "first_name": "ALICE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.