Active NPI
Serenity Slade
- Behavior Analyst
- Stafford, VA
National Provider Identifier
1760222103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- RBT-24-349386
- Practice address
- 188 Oville Rd
Stafford, VA 22556 - Phone
- (540) 645-4777
- NPI assigned
- May 31, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | RBT-24-349386 | VA | Primary |
Addresses
Primary practice location
188 Oville Rd
Stafford, VA 22556
Mailing address
188 Onville Rd
Stafford, VA 22556-3805
Phone (540) 645-4777
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-349386 | VA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1760222103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 ONVILLE RD",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225563805",
"telephone_number": "540-645-4777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 OVILLE RD",
"city": "STAFFORD",
"state": "VA",
"postal_code": "22556",
"telephone_number": "540-645-4777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLADE",
"first_name": "SERENITY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-31",
"last_updated": "2024-05-31",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "VA",
"license": "RBT-24-349386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stafford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.