Klaus Andres Vargas Machuca Martinez, RBT
Individual provider Active NPI Behavior Technician · Clarendon, NC
NPI 1750117651 · NPPES record last updated Sep 9, 2024
Key facts
- NPI
- 1750117651
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 3349 Mollie Rd
Clarendon, NC 28432-0017 - Phone
- (253) 330-6762
- NPI assigned
- Sep 9, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fresh Start Behavioral Services LLC | Behavior Technician | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician |
106S00000X | Yes |
Addresses
Primary practice location
3349 Mollie Rd
Clarendon, NC 28432-0017
Mailing address
2938 Ellesmere Cir
Myrtle Beach, SC 29579-6735
Phone (253) 330-6762
Other practice location 1
2938 Ellesmere Cir
Myrtle Beach, SC 29579-6735
Phone (253) 330-6762
Other providers in Clarendon, NC
All providers in Clarendon, NC · Behavior Technician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.