Individual provider Active NPI

Mary Stockebrand

  • Behavior Analyst
  • Sumter, SC
National Provider Identifier
1235713272
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-66224 Issued in SC
Practice address
1345 Companion CT
Sumter, SC 29150-1749
Phone
(803) 905-5107
Fax
(615) 815-1946
NPI assigned
May 6, 2021
Last updated
Aug 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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 1-23-66224 SC Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

1345 Companion CT
Sumter, SC 29150-1749

Mailing address

1321 Murfreesboro Pike Ste 410
Nashville, TN 37217-2665
Phone (615) 247-5487

Other names 1

  • Mary Strong Professional name

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": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1235713272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 MURFREESBORO PIKE STE 410",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372172665",
            "telephone_number": "615-247-5487",
            "fax_number": "615-815-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 COMPANION CT",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501749",
            "telephone_number": "803-905-5107",
            "fax_number": "615-815-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKEBRAND",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-06",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "SC",
            "license": "1-23-66224",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "STRONG",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.