Individual provider Active NPI

Meagan Martyniak Brown, M.S., BCBA

  • Behavior Analyst
  • Skokie, IL
National Provider Identifier
1639411374
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-12-12240 Issued in PA
Practice address
5225 Old Orchard Rd
Suite 17
Skokie, IL 60077-4405
Phone
(847) 983-0107
NPI assigned
Mar 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-12-12240 PA Primary

Addresses

Primary practice location

5225 Old Orchard Rd
Suite 17
Skokie, IL 60077-4405

Mailing address

5225 Old Orchard Road
Suite 17
Skokie, IL 60077
Phone (847) 983-0107

Other identifiers 1

IdentifierTypeStateIssuer
1-12-12240OtherPABEHAVIOR ANALYSIS CERTIFICATION BOARD

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
Credentials
Master of Science

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1639411374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 OLD ORCHARD ROAD",
            "address_2": "SUITE 17",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60077",
            "telephone_number": "847-983-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 OLD ORCHARD RD",
            "address_2": "SUITE 17",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774405",
            "telephone_number": "847-983-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MEAGAN",
        "middle_name": "MARTYNIAK",
        "name_prefix": "Mrs.",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "1-12-12240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYSIS CERTIFICATION BOARD",
            "identifier": "1-12-12240",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.