Individual provider Active NPI

Carly Adele Stetson

  • Behavior Analyst
  • San Antonio, TX
National Provider Identifier
1205287562
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-22140 Issued in NU
Practice address
838 NW Loop 410
San Antonio, TX 78216-5616
Phone
(210) 409-6561
NPI assigned
Jun 28, 2016
Last updated
Jun 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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 1-16-22140 NU Primary

Addresses

Primary practice location

838 NW Loop 410
San Antonio, TX 78216-5616

Mailing address

3330 Whisper MNR
Schertz, TX 78108-2165
Phone (210) 409-6561

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor Behavioral Approach LLC Behavior Analyst Current Accepting new patients
Prospera Healthcare Texas LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1205287562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 WHISPER MNR",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781082165",
            "telephone_number": "210-409-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 NW LOOP 410",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165616",
            "telephone_number": "210-409-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETSON",
        "first_name": "CARLY",
        "middle_name": "ADELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-16-22140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.