Active NPI
Cynthia Wortham, BCBA
- Behavior Analyst
- Jacksonville, NC
National Provider Identifier
1659930352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-1832148
- Practice address
- 603 New Bridge St
Jacksonville, NC 28540-5432 - Phone
- (910) 389-0901
- NPI assigned
- Jun 7, 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 Analyst | 103K00000X | 1-1832148 | NC | Primary |
Addresses
Primary practice location
603 New Bridge St
Jacksonville, NC 28540-5432
Mailing address
106 Granny Dr
Sneads Ferry, NC 28460-9403
Phone (910) 389-2790
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 |
|---|---|---|---|
| 1-1832148 | NC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559865600000",
"number": "1659930352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 GRANNY DR",
"city": "SNEADS FERRY",
"state": "NC",
"postal_code": "284609403",
"telephone_number": "910-389-2790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 NEW BRIDGE ST",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285405432",
"telephone_number": "910-389-0901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTHAM",
"first_name": "CYNTHIA",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-07",
"last_updated": "2019-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NC",
"license": "1-1832148",
"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 Jun 7, 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.