Active NPI
Carina Valencia Vanryck Degroot
- Behavior Technician
- West Orange, NJ
National Provider Identifier
1679228944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 1575544221
- Practice address
- 20 Beasley St
West Orange, NJ 07052-2901 - Phone
- (862) 400-6175
- NPI assigned
- Feb 15, 2022
- 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 Technician | 106S00000X | 1575544221 | NY | Primary |
Addresses
Primary practice location
20 Beasley St
West Orange, NJ 07052-2901
Mailing address
20 Beasley St
West Orange, NJ 07052-2901
Phone (862) 400-6175
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 |
|---|---|---|---|
| 1575544221 | NY | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644883200000",
"number": "1679228944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 BEASLEY ST",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522901",
"telephone_number": "862-400-6175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 BEASLEY ST",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522901",
"telephone_number": "862-400-6175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANRYCK DEGROOT",
"first_name": "CARINA",
"middle_name": "VALENCIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-15",
"last_updated": "2022-02-15",
"certification_date": "2022-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NY",
"license": "1575544221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.