Individual provider Active NPI

Janique Custis

  • Behavior Technician
  • Fayetteville, NC
National Provider Identifier
1477476315
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT Issued in NC
Practice address
2676 Eldorado Rd
Fayetteville, NC 28306-1913
Phone
(856) 288-6137
NPI assigned
Jul 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT NC Primary

Addresses

Primary practice location

2676 Eldorado Rd
Fayetteville, NC 28306-1913

Mailing address

2676 Eldorado Rd
Fayetteville, NC 28306-1913
Phone (856) 288-6137

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": "1785369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1477476315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2676 ELDORADO RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283061913",
            "telephone_number": "856-288-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2676 ELDORADO RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283061913",
            "telephone_number": "856-288-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTIS",
        "first_name": "JANIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-30",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "RBT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.

Verify at the official NPI Registry.