Individual provider Active NPI

Derricka Saunders

  • Behavior Analyst
  • Forest Hills, NY
National Provider Identifier
1720806276
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1846094241 Issued in NY
Practice address
11655 Queens Blvd Ste 216
Forest Hills, NY 11375-6527
Phone
(212) 804-7659
Fax
(888) 975-7704
NPI assigned
Oct 2, 2024
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1846094241 NY Primary

Addresses

Primary practice location

11655 Queens Blvd Ste 216
Forest Hills, NY 11375-6527

Mailing address

11655 Queens Blvd Ste 216
Forest Hills, NY 11375-6527
Phone (212) 804-7659

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
1846094241NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1720806276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11655 QUEENS BLVD STE 216",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756527",
            "telephone_number": "212-804-7659",
            "fax_number": "888-975-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11655 QUEENS BLVD STE 216",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756527",
            "telephone_number": "212-804-7659",
            "fax_number": "888-975-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "DERRICKA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1846094241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.