Individual provider Active NPI

Fernande Deguenon

  • Behavior Analyst
  • Germantown, MD
National Provider Identifier
1497480719
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA1317 Issued in MD
Practice address
18805 Sparkling Water Dr Apt T2
Germantown, MD 20874-2185
Phone
(347) 564-5679
NPI assigned
Jul 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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 LBA1317 MD Primary

Addresses

Primary practice location

18805 Sparkling Water Dr Apt T2
Germantown, MD 20874-2185

Mailing address

18805 Sparkling Water Dr Apt T2
Germantown, MD 20874-2185
Phone (347) 564-5679

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
LBA1317MDMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1497480719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18805 SPARKLING WATER DR APT T2",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742185",
            "telephone_number": "347-564-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18805 SPARKLING WATER DR APT T2",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742185",
            "telephone_number": "347-564-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGUENON",
        "first_name": "FERNANDE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "LBA1317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.