Individual provider Active NPI

Julisa Cerda, BA, RBT

  • Behavior Technician
  • Fayetteville, AR
National Provider Identifier
1740887686
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-127034 Issued in IN
Practice address
2418 E Joyce Blvd
Fayetteville, AR 72703-4519
Phone
(479) 521-8326
NPI assigned
Oct 5, 2020
Last updated
May 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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-20-127034 IN Primary

Addresses

Primary practice location

2418 E Joyce Blvd
Fayetteville, AR 72703-4519

Mailing address

2474 E Joyce Blvd Ste 2
Fayetteville, AR 72703-4932
Phone (479) 521-8326

Other practice location 1

3781 Bayley Dr Ste B
Lafayette, IN 47905-8657
Phone (765) 201-4767

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
RBT-20-127034INMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Therapy Services, Inc. PastSince May 21, 2023 Accepting new patients
Hopebridge, LLC Behavior Technician PastSince Oct 1, 2020 Accepting new patients
Children's Therapy Services, Inc PastSince May 21, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1740887686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2474 E JOYCE BLVD STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034932",
            "telephone_number": "479-521-8326",
            "fax_number": "479-521-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 E JOYCE BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034519",
            "telephone_number": "479-521-8326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3781 Bayley Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479058657",
            "country_code": "US",
            "telephone_number": "765-201-4767",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERDA",
        "first_name": "JULISA",
        "credential": "BA, RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-20-127034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.