Lisa Booth

Individual provider Active NPI Behavior Technician · Cameron, NC

NPI 1548027675 · NPPES record last updated Mar 5, 2024

Key facts

NPI
1548027675
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-23-274815 (NC)
Practice address
185 Mittie Haddock Dr
Cameron, NC 28326-9379
Phone
(910) 500-7783
NPI assigned
Mar 5, 2024
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-23-274815NCMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Autism Center Behavior Technician Current
since Mar 12, 2024
Accepting new patients

Locations

185 Mittie Haddock Dr
Cameron, NC 28326
Phone (910) 500-7783

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-274815 NC Yes

Addresses

Primary practice location

185 Mittie Haddock Dr
Cameron, NC 28326-9379

Mailing address

185 Mittie Haddock Dr
Cameron, NC 28326-9379
Phone (910) 500-7783

Other providers in Cameron, NC

All providers in Cameron, NC · Behavior Technician in North Carolina

Sources for this page

Verify at the official NPI Registry.