Active NPI
Melisa Gonzalez
- Behavior Technician
- Columbia, MD
National Provider Identifier
1295474393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 20-147270
- Practice address
- 10440 Little Patuxent Pkwy Ste 300
Columbia, MD 21044-3648 - Phone
- (617) 297-7998
- Fax
- (617) 340-3371
- NPI assigned
- May 27, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 20-147270 | MD | Primary |
Addresses
Primary practice location
10440 Little Patuxent Pkwy Ste 300
Columbia, MD 21044-3648
Mailing address
12927 Alderleaf Dr
Germantown, MD 20874-1140
Phone (240) 805-8901
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 |
|---|---|---|---|
| 20-147270 | MD | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653609600000",
"number": "1295474393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12927 ALDERLEAF DR",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208741140",
"telephone_number": "240-805-8901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10440 LITTLE PATUXENT PKWY STE 300",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210443648",
"telephone_number": "617-297-7998",
"fax_number": "617-340-3371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MELISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-27",
"last_updated": "2022-05-27",
"certification_date": "2022-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MD",
"license": "20-147270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.