Active NPI
Jessica Zidanic
- Behavior Technician
- Berlin, MD
National Provider Identifier
1366334088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-25-451198
- Practice address
- 617 Franklin Ave Unit 12
Berlin, MD 21811-1358 - Phone
- (302) 212-7091
- NPI assigned
- Jul 17, 2025
- Last updated
- Jul 17, 2025
- 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 | RBT-25-451198 | MD | Primary |
Addresses
Primary practice location
617 Franklin Ave Unit 12
Berlin, MD 21811-1358
Mailing address
617 Franklin Ave Unit 12
Berlin, MD 21811-1358
Phone (302) 212-7091
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 |
|---|---|---|---|
| RBT-25-451198 | MD | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752710400000",
"number": "1366334088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "617 FRANKLIN AVE UNIT 12",
"city": "BERLIN",
"state": "MD",
"postal_code": "218111358",
"telephone_number": "302-212-7091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 FRANKLIN AVE UNIT 12",
"city": "BERLIN",
"state": "MD",
"postal_code": "218111358",
"telephone_number": "302-212-7091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIDANIC",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-17",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MD",
"license": "RBT-25-451198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berlin, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.