Individual provider Active NPI

Ethan James Marxhausen

  • Behavior Technician
  • Woodbury, MN
National Provider Identifier
1285544544
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2080 Wooddale Dr Ste 200
Woodbury, MN 55125-2924
Phone
(651) 431-6628
NPI assigned
Sep 9, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

2080 Wooddale Dr Ste 200
Woodbury, MN 55125-2924

Mailing address

382 NE 191St St Ste 98090
Miami, FL 33179-3899
Phone (501) 282-0630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1285544544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 NE 191ST ST STE 98090",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331793899",
            "telephone_number": "501-282-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 WOODDALE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252924",
            "telephone_number": "651-431-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARXHAUSEN",
        "first_name": "ETHAN",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-09",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.