Active NPI
Autumn Benjamin
- Behavior Technician
- Humble, TX
National Provider Identifier
1265006308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 9240 Beltway 8 Unit 110
Humble, TX 77396 - Phone
- (855) 782-7822
- NPI assigned
- May 13, 2021
- Reactivated
- Jul 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | TX | ||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
9240 Beltway 8 Unit 110
Humble, TX 77396
Mailing address
9240 Beltway 8 Unit 110
Humble, TX 77396
Phone (855) 782-7822
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": "1620864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1265006308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9240 BELTWAY 8 UNIT 110",
"city": "HUMBLE",
"state": "TX",
"postal_code": "77396",
"telephone_number": "855-782-7822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9240 BELTWAY 8 UNIT 110",
"city": "HUMBLE",
"state": "TX",
"postal_code": "77396",
"telephone_number": "855-782-7822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "AUTUMN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-13",
"last_updated": "2022-08-02",
"certification_date": "2022-07-20",
"deactivation_date": "2021-09-28",
"reactivation_date": "2022-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.