Active NPI
Scott Allyn Roderick, BCBA
- Behavior Analyst
- Harwinton, CT
National Provider Identifier
1730626417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 163 Lead Mine Brook Rd
Harwinton, CT 06791-1315 - Phone
- (860) 338-3130
- Fax
- (855) 632-4963
- NPI assigned
- Jan 19, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
163 Lead Mine Brook Rd
Harwinton, CT 06791-1315
Mailing address
163 Lead Mine Brook Rd
Harwinton, CT 06791-1315
Phone (860) 338-3130
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quantum Behavioral Consulting, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- In Home Supportive Care Agency
- Harwinton, CT
- NPI 1245786003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1730626417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 LEAD MINE BROOK RD",
"city": "HARWINTON",
"state": "CT",
"postal_code": "067911315",
"telephone_number": "860-338-3130",
"fax_number": "855-632-4963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 LEAD MINE BROOK RD",
"city": "HARWINTON",
"state": "CT",
"postal_code": "067911315",
"telephone_number": "860-338-3130",
"fax_number": "855-632-4963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODERICK",
"first_name": "SCOTT",
"middle_name": "ALLYN",
"name_prefix": "Mr.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-19",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harwinton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.