Mark Thomas Warren

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

BACB774446 Issued in VA

Practice address

190 Cherry Hill Dr
Stafford, VA 22556-3654

Phone

(866) 565-7222

Fax

(877) 734-1914

NPI assigned

Mar 31, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Your Life ABA VA, LLC

  • Behavior Analyst
  • New York, NY
  • NPI 1023772001
  NPD

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1710627351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 RIVERLAND RD SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240143610",
            "telephone_number": "866-565-7222",
            "fax_number": "877-734-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CHERRY HILL DR",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225563654",
            "telephone_number": "866-565-7222",
            "fax_number": "877-734-1914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1314 Riverland Rd SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240143610",
            "country_code": "US",
            "telephone_number": "866-565-7222",
            "fax_number": "877-734-1914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "BACB774446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Michelle Walters
• Nancy Weakley Wanner
• Dana Ware, OTR/L
• Katherine R Ware, LMT
• Brianna Nicole Warner
• Kayla Washington
• Rita Marie Wasilewski
• Tamara R Watkins, PHD, LPC
• Christina Nicole Watson
• Cassandra Watts

• Behavior Technician in Stafford, VA
• Providers in Stafford, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.

Verify at the official NPI Registry.