Carolyn Mires, PHD

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

1324 Belmont St
Brockton, MA 02301-4435

Phone

(814) 470-5508

NPI assigned

Feb 10, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1275125148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BUNKER HILL RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602191",
            "telephone_number": "814-470-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014435",
            "telephone_number": "814-470-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRES",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cmires@ne-family.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1324 Belmont St",
            "city": "Brockton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023014435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Analyst in Brockton, MA
• Providers in Brockton, MA by specialty
• Behavior Analyst in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.