Active NPI
Deborah Elizabeth Beach
- Behavior Technician
- West Hartford, CT
National Provider Identifier
1629623970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 026302801
- Practice address
- 101 South St
West Hartford, CT 06110-1967 - Phone
- (860) 578-1300
- NPI assigned
- Aug 5, 2019
- 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 Technician | 106S00000X | 026302801 | CT | Primary |
Addresses
Primary practice location
101 South St
West Hartford, CT 06110-1967
Mailing address
28 Sanford St
Hartford, CT 06120-1915
Phone (860) 869-1936
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 |
|---|---|---|---|
| 026302801 | CT | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1629623970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 SANFORD ST",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061201915",
"telephone_number": "860-869-1936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 SOUTH ST",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061101967",
"telephone_number": "860-578-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEACH",
"first_name": "DEBORAH",
"middle_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-05",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "CT",
"license": "026302801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.