Active NPI
Michelle Wagenhoffer, MA, LBS
- Behavior Analyst
- Collegeville, PA
National Provider Identifier
1669039319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BH003142
- Practice address
- 4462 Buck Hollow Rd
Collegeville, PA 19426-4182 - Phone
- (215) 527-2124
- NPI assigned
- May 28, 2019
- 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 Analyst | 103K00000X | BH003142 | PA | Primary |
Addresses
Primary practice location
4462 Buck Hollow Rd
Collegeville, PA 19426-4182
Mailing address
308 Jasmine CT
Zieglerville, PA 19492-9726
Phone (267) 625-1599
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH003142 | PA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior and Education Support Services, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Collegeville, PA
- NPI 1447693023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559001600000",
"number": "1669039319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 JASMINE CT",
"city": "ZIEGLERVILLE",
"state": "PA",
"postal_code": "194929726",
"telephone_number": "267-625-1599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4462 BUCK HOLLOW RD",
"city": "COLLEGEVILLE",
"state": "PA",
"postal_code": "194264182",
"telephone_number": "215-527-2124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGENHOFFER",
"first_name": "MICHELLE",
"credential": "MA, LBS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-28",
"last_updated": "2019-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "BH003142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Collegeville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.