Active NPI
Victoria Poole
- Behavior Technician
- Summerville, SC
National Provider Identifier
1588337182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-143816
- Practice address
- 120 E 5TH North St
Summerville, SC 29483-6822 - Phone
- (843) 826-0665
- NPI assigned
- Jul 29, 2021
- 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-20-143816 | SC | Primary |
Addresses
Primary practice location
120 E 5TH North St
Summerville, SC 29483-6822
Mailing address
8404 Polo PT
North Charleston, SC 29418-2719
Phone (843) 597-4024
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-20-143816 | SC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632355200000",
"number": "1588337182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8404 POLO PT",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294182719",
"telephone_number": "843-597-4024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 E 5TH NORTH ST",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294836822",
"telephone_number": "843-826-0665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POOLE",
"first_name": "VICTORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-29",
"last_updated": "2021-09-23",
"certification_date": "2021-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "SC",
"license": "RBT-20-143816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.