Active NPI
Colleen Johnson, BCBA
- Behavior Analyst
- Beltsville, MD
National Provider Identifier
1407579261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA1403
- Practice address
- 12240 Indian Creek CT Ste 100
Beltsville, MD 20705-1242 - Phone
- (201) 979-1336
- Fax
- (908) 940-0338
- NPI assigned
- Sep 26, 2022
- Sex
- Female
- Sole proprietor
- No
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 Analyst | 103K00000X | LBA1403 | MD | Primary |
Addresses
Primary practice location
12240 Indian Creek CT Ste 100
Beltsville, MD 20705-1242
Mailing address
175 Belgrove Dr
Kearny, NJ 07032-1507
Phone (201) 979-1376
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 |
|---|---|---|---|
| LBA1403 | MD | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fowkes Consulting Co. | Behavior Analyst | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Brookeville, MD
- NPI 1316805005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771545600000",
"number": "1407579261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 BELGROVE DR",
"city": "KEARNY",
"state": "NJ",
"postal_code": "070321507",
"telephone_number": "201-979-1376",
"fax_number": "908-940-0338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12240 INDIAN CREEK CT STE 100",
"city": "BELTSVILLE",
"state": "MD",
"postal_code": "207051242",
"telephone_number": "201-979-1336",
"fax_number": "908-940-0338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "COLLEEN",
"name_prefix": "Mrs.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-26",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MD",
"license": "LBA1403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beltsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.