Active NPI
Redjina Nelson
- Behavior Technician
- Stoughton, MA
National Provider Identifier
1275346959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- S35302304
- Practice address
- 800 Technology Center Dr
Stoughton, MA 02072-4721 - Phone
- (781) 290-3886
- NPI assigned
- Jan 28, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | S35302304 | MA | Primary |
Addresses
Primary practice location
800 Technology Center Dr
Stoughton, MA 02072-4721
Mailing address
1150 Main St Brockton Mass
Brockton, MA 02301
Phone (508) 360-8662
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
| License | State | Type | Specialty |
|---|---|---|---|
| S35302304 | MA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1275346959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 MAIN ST BROCKTON MASS",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02301",
"telephone_number": "508-360-8662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 TECHNOLOGY CENTER DR",
"city": "STOUGHTON",
"state": "MA",
"postal_code": "020724721",
"telephone_number": "781-290-3886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "REDJINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-28",
"last_updated": "2025-01-28",
"certification_date": "2025-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": "S35302304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoughton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.