Alijah N Camp

Key facts

NPI

1740967892

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

1 Halloran Drive
St. Clairsville, OH 43950

Phone

(740) 296-5743

Fax

(740) 296-5952

NPI assigned

Jun 30, 2023

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 30, 2023.

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1740967892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21",
            "city": "SMITHFIELD",
            "state": "OH",
            "postal_code": "439480021",
            "telephone_number": "740-219-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HALLORAN DRIVE",
            "city": "ST. CLAIRSVILLE",
            "state": "OH",
            "postal_code": "43950",
            "telephone_number": "740-296-5743",
            "fax_number": "740-296-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMP",
        "first_name": "ALIJAH",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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