Individual provider Active NPI

Stephy Sebastian

  • Behavior Analyst
  • Philadelphia, PA
National Provider Identifier
1548853062
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BH005230 Issued in PA
Practice address
2200 Saint James PL
Philadelphia, PA 19103-5860
Phone
(856) 616-9442
NPI assigned
Feb 16, 2021
Last updated
Mar 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-21-54286 PA
Behavior Analyst 103K00000X BH005230 PA Primary

Addresses

Primary practice location

2200 Saint James PL
Philadelphia, PA 19103-5860

Mailing address

583 Shoemaker Rd Ste 230
King of Prussia, PA 19406-4238
Phone (484) 681-2170

Other practice location 1

583 Shoemaker Rd Ste 230
King Of Prussia, PA 19406-4238
Phone (484) 681-2170

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
BH005230PAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1548853062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 SHOEMAKER RD STE 230",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064238",
            "telephone_number": "484-681-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 SAINT JAMES PL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191035860",
            "telephone_number": "856-616-9442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "583 Shoemaker Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "King Of Prussia",
            "state": "PA",
            "postal_code": "194064238",
            "country_code": "US",
            "telephone_number": "484-681-2170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "STEPHY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "1-21-54286",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH005230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.