Manjuma Alam

Key facts

NPI

1619821063

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

3595 Sagamore Pkwy N
Lafayette, IN 47904-1095

Phone

(866) 727-8274

NPI assigned

Feb 23, 2026

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 4, 2026.

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1619821063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N HOLLYWOOD WAY STE 301",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915055025",
            "telephone_number": "866-727-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 SAGAMORE PKWY N",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479041095",
            "telephone_number": "866-727-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAM",
        "first_name": "MANJUMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Lafayette, IN · Behavior Technician in Indiana