Individual provider Active NPI

Julia Robertson, BCBA

  • Behavior Analyst
  • King of Prussia, PA
National Provider Identifier
1215443395
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-62246 Issued in NU
Practice address
601 S Henderson Rd.
#208
King of Prussia, PA 19406-3596
Phone
(267) 432-9354
Fax
(610) 768-0619
NPI assigned
Dec 27, 2017
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-22-62246 NU Primary
Behavior Technician 106S00000X RBT-16-1380-31914 VA

Addresses

Primary practice location

601 S Henderson Rd.
#208
King of Prussia, PA 19406-3596

Mailing address

108 E 2ND Ave
Parkesburg, PA 19365-1246

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

State licenses

LicenseStateTypeSpecialty
RBT-16-1380-31914VAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
NLS ABA Services LLC Past Accepting new patients

Organizations & group practices 1

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": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1215443395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E 2ND AVE",
            "city": "PARKESBURG",
            "state": "PA",
            "postal_code": "193651246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S HENDERSON RD.",
            "address_2": "#208",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063596",
            "telephone_number": "267-432-9354",
            "fax_number": "610-768-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JULIA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-27",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-22-62246",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "RBT-16-1380-31914",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.

Verify at the official NPI Registry.