Active NPI
Malik Kadeem Glenn
- Behavior Technician
- Washington DC, MD
National Provider Identifier
1407558935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1900 C St SE
Washington, DC, MD 20607 - Phone
- (202) 388-4300
- NPI assigned
- Mar 20, 2023
- Last updated
- Mar 20, 2023
- 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 | NU | Primary |
Addresses
Primary practice location
1900 C St SE
Washington, DC, MD 20607
Mailing address
1514 Saint Albans LN
Accokeek, MD 20607-2916
Phone (716) 510-1457
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": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679270400000",
"number": "1407558935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 SAINT ALBANS LN",
"city": "ACCOKEEK",
"state": "MD",
"postal_code": "206072916",
"telephone_number": "716-510-1457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 C ST SE",
"city": "WASHINGTON, DC",
"state": "MD",
"postal_code": "20607",
"telephone_number": "202-388-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "MALIK",
"middle_name": "KADEEM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-20",
"last_updated": "2023-03-20",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington DC, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.