Individual provider Active NPI

Sophia Moberly

  • Behavior Technician
  • Saginaw, MI
National Provider Identifier
1851016513
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5703 Bay Rd
Saginaw, MI 48604-2507
Phone
(989) 334-6167
NPI assigned
Oct 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

5703 Bay Rd
Saginaw, MI 48604-2507

Mailing address

2270 Maddy LN
Keego Harbor, MI 48320-1463
Phone (248) 520-6597

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": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1851016513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 MADDY LN",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "483201463",
            "telephone_number": "248-520-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5703 BAY RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042507",
            "telephone_number": "989-334-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBERLY",
        "first_name": "SOPHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.

Verify at the official NPI Registry.