Priscilla Marie Werner

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

45 Route 11
Shamokin Dam, PA 17876

Phone

(888) 726-4774

NPI assigned

Jul 22, 2022

Last updated

Jul 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Priscilla Marie Bloom Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1568197549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 ROUTE 11",
            "city": "SHAMOKIN DAM",
            "state": "PA",
            "postal_code": "17876",
            "telephone_number": "888-726-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ROUTE 11",
            "city": "SHAMOKIN DAM",
            "state": "PA",
            "postal_code": "17876",
            "telephone_number": "888-726-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "PRISCILLA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "gmail",
            "affiliation": "N",
            "address_1": "45 Route 11",
            "city": "shamokin Dam",
            "state": "PA",
            "country_code": "US",
            "postal_code": "17876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PRISCILLA",
            "last_name": "BLOOM",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Technician in Shamokin Dam, PA
• Providers in Shamokin Dam, PA by specialty
• Behavior Technician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.