Active NPI
Tracey Carpenter, LB BCBA
- Behavior Analyst
- Wake Forest, NC
National Provider Identifier
1508316357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 114
- Practice address
- 3331 Heritage Trade Dr Ste 110
Wake Forest, NC 27587-4346 - Phone
- (910) 507-0749
- Fax
- (910) 518-5227
- NPI assigned
- Oct 5, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-16-22922 | ||
| Behavior Analyst | 103K00000X | 114 | NC | Primary |
Addresses
Primary practice location
3331 Heritage Trade Dr Ste 110
Wake Forest, NC 27587-4346
Mailing address
106 Friendly LN
Hampstead, NC 28443-2663
Phone (910) 507-0749
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": "1475625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747872000000",
"number": "1508316357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 FRIENDLY LN",
"city": "HAMPSTEAD",
"state": "NC",
"postal_code": "284432663",
"telephone_number": "910-507-0749",
"fax_number": "910-518-5227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3331 HERITAGE TRADE DR STE 110",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275874346",
"telephone_number": "910-507-0749",
"fax_number": "910-518-5227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "TRACEY",
"credential": "LB BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-05",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-16-22922",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NC",
"license": "114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.