Active NPI
Anthony Lamont Mickey, RBT
- Behavior Technician
- Woodmere, NY
National Provider Identifier
1376356782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB962783
- Practice address
- 945 N Central Ave
Woodmere, NY 11598-1604 - Phone
- (385) 354-5250
- NPI assigned
- Jan 29, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | BACB962783 | UT | Primary |
Addresses
Primary practice location
945 N Central Ave
Woodmere, NY 11598-1604
Mailing address
6211 S Highland Dr # 4032
Holladay, UT 84121-2125
Phone (804) 928-1734
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 |
|---|---|---|---|
| BACB962783 | UT | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1376356782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6211 S HIGHLAND DR # 4032",
"city": "HOLLADAY",
"state": "UT",
"postal_code": "841212125",
"telephone_number": "804-928-1734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 N CENTRAL AVE",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115981604",
"telephone_number": "385-354-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKEY",
"first_name": "ANTHONY",
"middle_name": "LAMONT",
"name_prefix": "Mr.",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-29",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "UT",
"license": "BACB962783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodmere, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.