Active NPI
Brena Potts
- Behavior Technician
- Jacksonville, NC
National Provider Identifier
1619826989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 25-499895
- Practice address
- 43 Office Park Dr
Jacksonville, NC 28546-3220 - Phone
- (888) 392-8642
- Fax
- (888) 783-7611
- NPI assigned
- Jan 28, 2026
- Last updated
- Jan 28, 2026
- 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 | 25-499895 | NU | Primary |
Addresses
Primary practice location
43 Office Park Dr
Jacksonville, NC 28546-3220
Mailing address
107 S Cambridge St
Hubert, NC 28539-9700
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Living Experience, LLC | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Opal Autism Centers
- Behavior Analyst
- Charlotte, NC
- NPI 1437800604
Behavior Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769558400000",
"number": "1619826989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 S CAMBRIDGE ST",
"city": "HUBERT",
"state": "NC",
"postal_code": "285399700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 OFFICE PARK DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285463220",
"telephone_number": "888-392-8642",
"fax_number": "888-783-7611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTS",
"first_name": "BRENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-28",
"last_updated": "2026-01-28",
"certification_date": "2026-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": "25-499895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.