Active NPI
Iesha T Phelps
- Behavior Technician
- Pittston, PA
National Provider Identifier
1811634553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1081 Oak St Ste 3
Pittston, PA 18640-3716 - Phone
- (888) 726-4774
- Fax
- (570) 362-5112
- NPI assigned
- May 15, 2022
- Last updated
- May 15, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Respiratory/Developmental/Rehabilitative Specialist/Technologist | 225500000X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1081 Oak St Ste 3
Pittston, PA 18640-3716
Mailing address
9 Banks Ave
McAdoo, PA 18237-2508
Phone (888) 726-4774
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 |
|---|---|---|---|
| Mission Autism Clinics LLC | Single Specialty | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652572800000",
"number": "1811634553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 BANKS AVE",
"city": "MCADOO",
"state": "PA",
"postal_code": "182372508",
"telephone_number": "888-726-4774",
"fax_number": "570-362-5112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1081 OAK ST STE 3",
"city": "PITTSTON",
"state": "PA",
"postal_code": "186403716",
"telephone_number": "888-726-4774",
"fax_number": "570-362-5112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELPS",
"first_name": "IESHA",
"middle_name": "T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-15",
"last_updated": "2022-05-15",
"certification_date": "2022-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "225500000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittston, PA
- Taylor Maria Pavlick
- Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #02729)
- Kamakarra Perkins
- Karina Geronilla Phang, MD
- Pharmacy Corporation of America (PharMerica)
- Physical Therapy Center Unlimited
- Ashley Elizabeth Pierson
- Jacqueline Rose Pinto, PTA
- Pittston Medical Associates LTD.
- Pittston Medical Associates, LTD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.