Amy Patterson, BCBA, LBA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

15245 Shady Grove Rd Ste 320
Rockville, MD 20850-6280

Phone

(301) 882-6060

NPI assigned

Mar 1, 2016

Reactivated

Mar 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Wong Former name

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": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1609236983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15251 SIESTA KEY WAY APT 529",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208505524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 SHADY GROVE RD STE 320",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506280",
            "telephone_number": "301-882-6060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "329 E 149th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104515601",
            "country_code": "US",
            "telephone_number": "718-769-2698 x296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "AMY",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "deactivation_date": "2020-03-07",
        "reactivation_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "WONG",
            "credential": "BCBA, LBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexandria Patrick
• Ashely Patrick
• Dominique Patrick
• Krystal Patrick
• William Quell Patrick Jr., CSA
• Haley Patterson
• Starnisha Patterson
• Tyler Patterson
• Tyler Patterson
• Amber Patton

• Professional Counselor in Rockville, MD
• Providers in Rockville, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; 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.