NPIMap

Organization Active NPI

Child'S Play Behavior Analysis

  • Behavior Analyst
  • Roanoke, IN
National Provider Identifier
1306133681
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1107501 Issued in IL
Legal business name
CHILD'S PLAY BEHAVIOR ANALYSIS
Practice address
670 Chadings Dr
Roanoke, IN 46783-8875
Phone
(423) 582-9494
NPI assigned
Jul 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Authorized official

Name
Rebecca Marie-Rose Fulcher, MA, BCBANPI 1366744518
Title
Behavior Analyst
Phone
(423) 582-9494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1107501 IL Primary

Addresses

Primary practice location

670 Chadings Dr
Roanoke, IN 46783-8875

Mailing address

670 Chadings Dr
Roanoke, IN 46783-8875
Phone (423) 582-9494

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358726400000",
    "number": "1306133681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 CHADINGS DR",
            "city": "ROANOKE",
            "state": "IN",
            "postal_code": "467838875",
            "telephone_number": "423-582-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 CHADINGS DR",
            "city": "ROANOKE",
            "state": "IN",
            "postal_code": "467838875",
            "telephone_number": "423-582-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD'S PLAY BEHAVIOR ANALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2013-01-21",
        "status": "A",
        "authorized_official_last_name": "FULCHER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "MARIE-ROSE",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "423-582-9494",
        "authorized_official_credential": "MA, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1107501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; 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.