Active NPI
Pharel Simon Justin
- Behavior Technician
- Huntsville, AL
National Provider Identifier
1760294656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 306 Wynn Dr NW
Huntsville, AL 35805-1961 - Phone
- (256) 882-2457
- Fax
- (256) 882-2459
- NPI assigned
- Jan 27, 2025
- 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 | AL | Primary |
Addresses
Primary practice location
306 Wynn Dr NW
Huntsville, AL 35805-1961
Mailing address
500 Providence Main St NW Apt 9301
Huntsville, AL 35806-4891
Phone (845) 417-3562
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Riley Behavioral and Educational Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Developmental Therapist
- Huntsville, AL
- NPI 1215156872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737936000000",
"number": "1760294656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 PROVIDENCE MAIN ST NW APT 9301",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358064891",
"telephone_number": "845-417-3562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 WYNN DR NW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358051961",
"telephone_number": "256-882-2457",
"fax_number": "256-882-2459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUSTIN",
"first_name": "PHAREL",
"middle_name": "SIMON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-27",
"last_updated": "2025-01-27",
"certification_date": "2025-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.