Individual provider Active NPI

Mira-Cler Joy Josaiah

  • Behavior Technician
  • Springfield, IL
National Provider Identifier
1710559281
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4200 Conestoga Dr
Springfield, IL 62711-7934
Phone
(630) 286-0026
Fax
(847) 908-7541
NPI assigned
Jul 14, 2021
Last updated
Jul 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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 Primary

Addresses

Primary practice location

4200 Conestoga Dr
Springfield, IL 62711-7934

Mailing address

2616 Mahogany Dr Apt 73
Bloomington, IL 61704-4794
Phone (847) 910-4692

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

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1710559281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 MAHOGANY DR APT 73",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044794",
            "telephone_number": "847-910-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 CONESTOGA DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117934",
            "telephone_number": "630-286-0026",
            "fax_number": "847-908-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSAIAH",
        "first_name": "MIRA-CLER",
        "middle_name": "JOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.