Individual provider Active NPI

Andrea Revae Herrington, BCBA

  • Behavior Analyst
  • Prattville, AL
National Provider Identifier
1639634934
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2019-010 Issued in AL
Practice address
114 Medical Center Dr
Prattville, AL 36066-7286
Phone
(334) 491-3020
NPI assigned
Jan 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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 2019-010 AL Primary

Addresses

Primary practice location

114 Medical Center Dr
Prattville, AL 36066-7286

Mailing address

5392 Mason Rd
Hope Hull, AL 36043-5905
Phone (334) 504-0108

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

LicenseStateTypeSpecialty
2019-010ALMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1639634934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5392 MASON RD",
            "city": "HOPE HULL",
            "state": "AL",
            "postal_code": "360435905",
            "telephone_number": "334-504-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 MEDICAL CENTER DR",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667286",
            "telephone_number": "334-491-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRINGTON",
        "first_name": "ANDREA",
        "middle_name": "REVAE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "2019-010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.

Verify at the official NPI Registry.