Active NPI
Jessica Marie Elizabeth Marks
- Behavior Technician
- Sterling, VA
National Provider Identifier
1548995384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-222627
- Practice address
- 22375 Broderick Dr Ste 125
Sterling, VA 20166-9345 - Phone
- (571) 375-0214
- NPI assigned
- Jul 17, 2022
- 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 Technician | 106S00000X | RBT-22-222627 | VA | Primary |
Addresses
Primary practice location
22375 Broderick Dr Ste 125
Sterling, VA 20166-9345
Mailing address
44780 Ashlar Ter Apt 204
Ashburn, VA 20147-4279
Phone (443) 510-2347
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-222627 | VA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658016000000",
"number": "1548995384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44780 ASHLAR TER APT 204",
"city": "ASHBURN",
"state": "VA",
"postal_code": "201474279",
"telephone_number": "443-510-2347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22375 BRODERICK DR STE 125",
"city": "STERLING",
"state": "VA",
"postal_code": "201669345",
"telephone_number": "571-375-0214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "JESSICA",
"middle_name": "MARIE ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-17",
"last_updated": "2022-07-17",
"certification_date": "2022-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "RBT-22-222627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.