Individual provider Active NPI

Alexandra Sumida

  • Behavior Technician
  • Troy, IL
National Provider Identifier
1356253850
Registry record updated Sep 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB1591449 Issued in IL
Practice address
411 Edwardsville Rd
Troy, IL 62294-1339
Phone
(618) 503-3107
Fax
(618) 500-3107
NPI assigned
Sep 19, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 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 BACB1591449 IL Primary

Addresses

Primary practice location

411 Edwardsville Rd
Troy, IL 62294-1339

Mailing address

411 Edwardsville Rd
Troy, IL 62294-1339
Phone (618) 503-3107

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": "1789776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789776000000",
    "number": "1356253850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 EDWARDSVILLE RD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622941339",
            "telephone_number": "618-503-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 EDWARDSVILLE RD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622941339",
            "telephone_number": "618-503-3107",
            "fax_number": "618-500-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMIDA",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-19",
        "last_updated": "2026-09-19",
        "certification_date": "2026-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "BACB1591449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.