Active NPI
Colleen Whitaker, M.ED. BCBA LBA
- Behavior Analyst
- Rockville, MD
National Provider Identifier
1487245221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 250
- Practice address
- 11614 Seven Locks Rd
Rockville, MD 20854-3261 - Phone
- (301) 469-0223
- NPI assigned
- Feb 2, 2021
- 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 Analyst | 103K00000X | 250 | MD | Primary |
Addresses
Primary practice location
11614 Seven Locks Rd
Rockville, MD 20854-3261
Mailing address
360 Wiregrass LN
Southern Pines, NC 28387-3062
Phone (925) 785-8986
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-16-22211 | Other | MD | BCBA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 250 | MD | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Ivymount School, Inc | Past | Accepting new patients | |
| Ivymount Outreach Programs, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Rockville, MD
- NPI 1881960912
-
- Developmentally Disabled Services Day Training Agency
- Rockville, MD
- NPI 1922485614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1487245221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 WIREGRASS LN",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283873062",
"telephone_number": "925-785-8986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11614 SEVEN LOCKS RD",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208543261",
"telephone_number": "301-469-0223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITAKER",
"first_name": "COLLEEN",
"credential": "M.ED. BCBA LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-02",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MD",
"license": "250",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA",
"identifier": "1-16-22211",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.