Individual provider Active NPI

Elizabet Guzman Serrano

  • Behavior Analyst
  • Inman, SC
National Provider Identifier
1467939231
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-68596 Issued in SC
Practice address
616 Brimley CT
Inman, SC 29349-8844
Phone
(561) 563-9624
NPI assigned
Jul 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-23-68596 SC Primary
Behavior Technician 106S00000X RBT-17-34530 FL

Addresses

Primary practice location

616 Brimley CT
Inman, SC 29349-8844

Mailing address

616 Brimley CT
Inman, SC 29349-8844
Phone (561) 563-9624

Other identifiers 1

IdentifierTypeStateIssuer
018677800MedicaidFL

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

LicenseStateTypeSpecialty
RBT-17-34530FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartlinks ABA in LLC Behavior Analyst Past 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.

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1467939231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 BRIMLEY CT",
            "city": "INMAN",
            "state": "SC",
            "postal_code": "293498844",
            "telephone_number": "561-563-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 BRIMLEY CT",
            "city": "INMAN",
            "state": "SC",
            "postal_code": "293498844",
            "telephone_number": "561-563-9624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "ELIZABET",
        "middle_name": "GUZMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "SC",
            "license": "1-23-68596",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-17-34530",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018677800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inman, SC

Sources for this page

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

Verify at the official NPI Registry.