Matthew Conklin

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

BACB662298 Issued in VA

Practice address

7771 Ashton Ave
Manassas, VA 20109-2879

Phone

(703) 492-2686

NPI assigned

May 10, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1841874328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 TITO CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201106172",
            "telephone_number": "703-895-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7771 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092879",
            "telephone_number": "703-492-2686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "BACB662298",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "BACB662298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Internal Medicine Associates
• Comprehensive Sleep Care Center Inc
• Fern B.E.L. Compton, CD(DONA)
• Jacqueline E Concaugh-Gruendel, PA
• Dieu-Tien Le Cong
• Angela Le'Che Conner, LPC
• Arien Conner, LCSW
• Monique Connor, LCSW
• Nicole Connor
• Hildy Lynn Conrad

• Behavior Technician in Manassas, VA
• Providers in Manassas, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.