Individual provider Active NPI

Nicole Christine Arielle Star

  • Behavior Technician
  • MC Lean, VA
National Provider Identifier
1386150704
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1651 Old Meadow Rd Ste 600
MC Lean, VA 22102-4389
Phone
(703) 506-0123
Fax
(703) 734-1932
NPI assigned
Dec 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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 Primary

Addresses

Primary practice location

1651 Old Meadow Rd Ste 600
MC Lean, VA 22102-4389

Mailing address

PO Box 282
Occoquan, VA 22125-0282
Phone (915) 539-2778

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

NPI Registry JSON

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1386150704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 282",
            "city": "OCCOQUAN",
            "state": "VA",
            "postal_code": "221250282",
            "telephone_number": "915-539-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 OLD MEADOW RD STE 600",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024389",
            "telephone_number": "703-506-0123",
            "fax_number": "703-734-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAR",
        "first_name": "NICOLE",
        "middle_name": "CHRISTINE ARIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.