Individual provider Active NPI

Mickenson St-Pierre

  • Behavior Technician
  • Plymouth, MA
National Provider Identifier
1205749967
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-487504 Issued in MA
Practice address
5 Natalie Way
Plymouth, MA 02360-3557
Phone
(774) 351-0299
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-25-487504 MA Primary

Addresses

Primary practice location

5 Natalie Way
Plymouth, MA 02360-3557

Mailing address

738 Plain St Apt 9
Marshfield, MA 02050-2101
Phone (857) 303-6319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1205749967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 PLAIN ST APT 9",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020502101",
            "telephone_number": "857-303-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 NATALIE WAY",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023603557",
            "telephone_number": "774-351-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST-PIERRE",
        "first_name": "MICKENSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MA",
            "license": "RBT-25-487504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.