Individual provider Active NPI

Spencer Evelyn, RBT

  • Behavior Technician
  • Bridgewater, NJ
National Provider Identifier
1679256291
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-244074 Issued in NJ
Practice address
120 Finderne Ave
Bridgewater, NJ 08807-3670
Phone
(908) 392-4976
Fax
(484) 377-2100
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-22-244074 NJ Primary

Addresses

Primary practice location

120 Finderne Ave
Bridgewater, NJ 08807-3670

Mailing address

120 Finderne Ave
Bridgewater, NJ 08807-3670
Phone (908) 392-4976

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
RBT-22-244074NJMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1679256291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 FINDERNE AVE",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073670",
            "telephone_number": "908-392-4976",
            "fax_number": "484-377-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 FINDERNE AVE",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073670",
            "telephone_number": "908-392-4976",
            "fax_number": "484-377-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVELYN",
        "first_name": "SPENCER",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NJ",
            "license": "RBT-22-244074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.