Active NPI
Michaela Amaris Moreno
- Behavior Analyst
- Summerville, SC
National Provider Identifier
1619678117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- RBT-23252517
- Practice address
- 144 Sweet Cherry LN
Summerville, SC 29486-8135 - Phone
- (650) 444-4654
- NPI assigned
- Mar 13, 2023
- Last updated
- Mar 13, 2023
- 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 Analyst | 103K00000X | RBT-23252517 | RI | Primary |
Addresses
Primary practice location
144 Sweet Cherry LN
Summerville, SC 29486-8135
Mailing address
144 Sweet Cherry LN
Summerville, SC 29486-8135
Phone (650) 444-4654
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-23252517 | RI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1619678117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 SWEET CHERRY LN",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294868135",
"telephone_number": "650-444-4654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "144 SWEET CHERRY LN",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294868135",
"telephone_number": "650-444-4654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "MICHAELA",
"middle_name": "AMARIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-13",
"last_updated": "2023-03-13",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "RI",
"license": "RBT-23252517",
"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 Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.