Individual provider Active NPI

Imani Bibuld

  • Behavior Technician
  • Newton, MA
National Provider Identifier
1396653747
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
109 Oak St Ste G20
Newton, MA 02464-1492
Phone
(617) 658-5611
NPI assigned
Aug 28, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 MA Primary

Addresses

Primary practice location

109 Oak St Ste G20
Newton, MA 02464-1492

Mailing address

109 Oak St Ste G20
Newton, MA 02464-1492
Phone (617) 658-5611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1396653747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 OAK ST STE G20",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641492",
            "telephone_number": "617-658-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 OAK ST STE G20",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641492",
            "telephone_number": "617-658-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBULD",
        "first_name": "IMANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-28",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.