Individual provider Active NPI

Timothy Justin Harden

  • Behavior Technician
  • Winston Salem, NC
National Provider Identifier
1679459788
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-1745-753777 Issued in NC
Practice address
720 Coliseum Dr
Winston Salem, NC 27106-5355
Phone
(743) 255-4568
NPI assigned
Aug 13, 2025
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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-25-1745-753777 NC Primary

Addresses

Primary practice location

720 Coliseum Dr
Winston Salem, NC 27106-5355

Mailing address

720 Coliseum Dr
Winston Salem, NC 27106-5355
Phone (743) 255-4568

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-25-1745-753777NCMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1679459788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 COLISEUM DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065355",
            "telephone_number": "743-255-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 COLISEUM DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065355",
            "telephone_number": "743-255-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEN",
        "first_name": "TIMOTHY",
        "middle_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "RBT-25-1745-753777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.