Active NPI
Breanna Kay Lang
- Behavior Technician
- Fargo, ND
National Provider Identifier
1457039398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 4152 30TH Ave S
Fargo, ND 58104-8524 - Phone
- (701) 364-2663
- NPI assigned
- Jul 10, 2023
- 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 Technician | 106S00000X | ND | Primary |
Addresses
Primary practice location
4152 30TH Ave S
Fargo, ND 58104-8524
Mailing address
4152 30TH Ave S
Fargo, ND 58104-8524
Phone (701) 364-2663
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anne Carlsen Center | Behavior Technician | Current | Accepting new patients |
Locations
4152 30th Ave S
Fargo, ND 58104
Phone (701) 364-2663
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1457039398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4152 30TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581048524",
"telephone_number": "701-364-2663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4152 30TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581048524",
"telephone_number": "701-364-2663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANG",
"first_name": "BREANNA",
"middle_name": "KAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-10",
"last_updated": "2023-07-10",
"certification_date": "2023-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "ND",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.