Active NPI
Carrie Hagstrom, MS, BACB, LBA
- Behavior Analyst
- Eldersburg, MD
National Provider Identifier
1740957737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA786
- Practice address
- 6505 Ridenour Way E
Eldersburg, MD 21784-6557 - Phone
- (410) 381-7171
- Fax
- (410) 381-4480
- NPI assigned
- Aug 26, 2021
- Sex
- Female
- 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 | LBA786 | MD | Primary |
Addresses
Primary practice location
6505 Ridenour Way E
Eldersburg, MD 21784-6557
Mailing address
6355 Woodside CT
Columbia, MD 21046-1071
Phone (410) 381-7171
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LBA786 | MD | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1740957737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6355 WOODSIDE CT",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210461071",
"telephone_number": "410-381-7171",
"fax_number": "410-381-4480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6505 RIDENOUR WAY E",
"city": "ELDERSBURG",
"state": "MD",
"postal_code": "217846557",
"telephone_number": "410-381-7171",
"fax_number": "410-381-4480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGSTROM",
"first_name": "CARRIE",
"credential": "MS, BACB, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MD",
"license": "LBA786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eldersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.