Individual provider Active NPI

Marley Olejnik, BCBA

  • Behavior Analyst
  • Woodruff, SC
National Provider Identifier
1790139657
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-21683 Issued in SC
Practice address
751 E. Georgia St.
Woodruff, SC 29388-8787
Phone
(864) 476-7400
Fax
(864) 476-0033
NPI assigned
Apr 18, 2016
Last updated
Apr 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-16-21683 SC Primary

Addresses

Primary practice location

751 E. Georgia St.
Woodruff, SC 29388-8787

Mailing address

751 E. Georgia St.
Woodruff, SC 29388-8787
Phone (864) 476-7400

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1790139657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 E. GEORGIA ST.",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293888787",
            "telephone_number": "864-476-7400",
            "fax_number": "864-476-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 E. GEORGIA ST.",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293888787",
            "telephone_number": "864-476-7400",
            "fax_number": "864-476-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLEJNIK",
        "first_name": "MARLEY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "SC",
            "license": "1-16-21683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodruff, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.