Individual provider Active NPI

Stacy Stewart, RBT

  • Behavior Technician
  • Tucson, AZ
National Provider Identifier
1376046656
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-17-40772 Issued in AZ
Practice address
1955 W Grant Rd Ste 180
Tucson, AZ 85745-1475
Phone
(844) 333-6642
Fax
(520) 333-3060
NPI assigned
Mar 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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 RBT-17-40772 AZ Primary

Addresses

Primary practice location

1955 W Grant Rd Ste 180
Tucson, AZ 85745-1475

Mailing address

8011 E 8TH St
Tucson, AZ 85710-2419
Phone (201) 280-8442

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
RBT-17-40772AZMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Optima Behavioral Consulting, LLC Past Accepting new patients
Optima Behavioral Consulting, LLC 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": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1376046656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8011 E 8TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102419",
            "telephone_number": "201-280-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 W GRANT RD STE 180",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451475",
            "telephone_number": "844-333-6642",
            "fax_number": "520-333-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "STACY",
        "name_prefix": "Ms.",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AZ",
            "license": "RBT-17-40772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.