Active NPI
Derrian Williams
- Behavior Analyst
- Ridgefield, NJ
National Provider Identifier
1609686526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BACB755906
- Practice address
- 855 Broad Ave Apt 42
Ridgefield, NJ 07657-1032 - Phone
- (860) 215-6428
- NPI assigned
- Jan 13, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 Analyst | 103K00000X | BACB755906 | NJ | Primary |
Addresses
Primary practice location
855 Broad Ave Apt 42
Ridgefield, NJ 07657-1032
Mailing address
855 Broad Ave Apt 42
Ridgefield, NJ 07657-1032
Phone (860) 215-6428
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 |
|---|---|---|---|
| BACB755906 | NJ | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736726400000",
"number": "1609686526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 BROAD AVE APT 42",
"city": "RIDGEFIELD",
"state": "NJ",
"postal_code": "076571032",
"telephone_number": "860-215-6428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 BROAD AVE APT 42",
"city": "RIDGEFIELD",
"state": "NJ",
"postal_code": "076571032",
"telephone_number": "860-215-6428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DERRIAN",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-13",
"last_updated": "2025-01-13",
"certification_date": "2025-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NJ",
"license": "BACB755906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgefield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.