Active NPI
Kayla Cierra Elaine Clark
- Behavior Technician
- Silver Spring, MD
National Provider Identifier
1639985609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-397061
- Practice address
- 12210 Plum Orchard Dr Ste 21
Silver Spring, MD 20904-7911 - Phone
- (718) 215-5311
- Fax
- (718) 865-5165
- NPI assigned
- Dec 5, 2024
- 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 | RBT-24-397061 | DC | Primary |
Addresses
Primary practice location
12210 Plum Orchard Dr Ste 21
Silver Spring, MD 20904-7911
Mailing address
PO Box 360595
Pittsburgh, PA 15251-6595
Phone (718) 215-5311
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 |
|---|---|---|---|
| RBT-24-397061 | DC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1639985609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 360595",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152516595",
"telephone_number": "718-215-5311",
"fax_number": "718-865-5165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12210 PLUM ORCHARD DR STE 21",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209047911",
"telephone_number": "718-215-5311",
"fax_number": "718-865-5165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "KAYLA",
"middle_name": "CIERRA ELAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-05",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "DC",
"license": "RBT-24-397061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.