NPIMap

Individual provider Active NPI

Carol Ann Haggerty, BCBA

  • Behavior Analyst
  • Marlton, NJ
National Provider Identifier
1326489485
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
3002 Lincoln Dr W
Suite E
Marlton, NJ 08053-1527
Phone
(856) 810-7599
Fax
(856) 751-8303
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

3002 Lincoln Dr W
Suite E
Marlton, NJ 08053-1527

Mailing address

3002 Lincoln Dr W
Suite E
Marlton, NJ 08053-1527
Phone (856) 810-7599

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

Practice roles

OrganizationSpecialtyStatusNew patients
Interactive Kids LLC Past Accepting new patients
Interactive Kids, LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1326489485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 LINCOLN DR W",
            "address_2": "SUITE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531527",
            "telephone_number": "856-810-7599",
            "fax_number": "856-751-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 LINCOLN DR W",
            "address_2": "SUITE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531527",
            "telephone_number": "856-810-7599",
            "fax_number": "856-751-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.