Active NPI
Brent Logan, M.A, RBT
- Behavior Technician
- Dumfries, VA
National Provider Identifier
1750034120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB724383
- Practice address
- 3322 William Johnston LN Apt 32
Dumfries, VA 22026-2163 - Phone
- (703) 434-0879
- NPI assigned
- Jan 27, 2022
- 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 Technician | 106S00000X | BACB724383 | VA | Primary |
Addresses
Primary practice location
3322 William Johnston LN Apt 32
Dumfries, VA 22026-2163
Mailing address
3322 William Johnston LN Apt 32
Dumfries, VA 22026-2163
Phone (703) 434-0879
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BACB724383 | VA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643241600000",
"number": "1750034120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3322 WILLIAM JOHNSTON LN APT 32",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "220262163",
"telephone_number": "703-434-0879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3322 WILLIAM JOHNSTON LN APT 32",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "220262163",
"telephone_number": "703-434-0879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "BRENT",
"name_prefix": "Mr.",
"credential": "M.A, RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-27",
"last_updated": "2022-01-27",
"certification_date": "2022-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "BACB724383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dumfries, VA
- Learning Through Love, LLC
- Linda A Lee, PHARM D
- Legacy Home Solutions
- Sara Beth Levin, MD
- Marie Nichole Livesey
- Amanda Lorge Johnson, FNP-C
- Loudoun Medical Group, PC (Comprehensive Sleep Care Center)
- Angela Yvonne Love, VA
- Loving Hands Transportation Services, LLC
- Lucid Healthcare Services LLC (Lucid Healthcare Services)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.