Individual provider Active NPI

Deborah N. Michiels, BCBA

  • Behavior Analyst
  • Wyckoff, NJ
National Provider Identifier
1417614504
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-55782 Issued in NJ
Practice address
230 Braen Ave Ste D
Wyckoff, NJ 07481-2948
Phone
(973) 423-2254
NPI assigned
Nov 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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 1-21-55782 NJ Primary

Addresses

Primary practice location

230 Braen Ave Ste D
Wyckoff, NJ 07481-2948

Mailing address

533 Eugene Way
Wyckoff, NJ 07481-2103
Phone (718) 406-5855

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": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1417614504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 EUGENE WAY",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812103",
            "telephone_number": "718-406-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 BRAEN AVE STE D",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812948",
            "telephone_number": "973-423-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHIELS",
        "first_name": "DEBORAH",
        "middle_name": "N.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "1-21-55782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.