Individual provider Active NPI

Christopher Duck, M.ED., BCBA

  • Behavior Analyst
  • Ellicott City, MD
National Provider Identifier
1417347295
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA008 Issued in MD
Practice address
3809 Graceland CT
Ellicott City, MD 21042-3764
Phone
(410) 868-6470
NPI assigned
Jan 30, 2015
Last updated
Apr 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA008 MD Primary

Addresses

Primary practice location

3809 Graceland CT
Ellicott City, MD 21042-3764

Mailing address

3809 Graceland CT
Ellicott City, MD 21042-3764
Phone (410) 868-6470

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
LBA008MDMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1417347295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 GRACELAND CT",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423764",
            "telephone_number": "410-868-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 GRACELAND CT",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423764",
            "telephone_number": "410-868-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCK",
        "first_name": "CHRISTOPHER",
        "credential": "M.ED., BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "LBA008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.