Individual provider Active NPI

Sofia Weedon

  • Behavior Technician
  • Danvers, MA
National Provider Identifier
1366154205
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
S45782305 Issued in MA
Practice address
6 Southside Rd
Danvers, MA 01923-1409
Phone
(978) 762-8352
NPI assigned
Dec 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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 S45782305 MA Primary

Addresses

Primary practice location

6 Southside Rd
Danvers, MA 01923-1409

Mailing address

6 Southside Rd
Danvers, MA 01923-1409
Phone (978) 762-8352

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

LicenseStateTypeSpecialty
S45782305MAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1366154205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 SOUTHSIDE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231409",
            "telephone_number": "978-762-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 SOUTHSIDE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231409",
            "telephone_number": "978-762-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEDON",
        "first_name": "SOFIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MA",
            "license": "S45782305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.

Verify at the official NPI Registry.