Individual provider Active NPI

Regina Krickeberg

  • Behavior Technician
  • Woodbury, MN
National Provider Identifier
1861203614
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
731 Bielenberg Dr Ste 102-104
Woodbury, MN 55125-1700
Phone
(612) 435-8326
NPI assigned
Jan 20, 2025
Last updated
Jan 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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 NU Primary

Addresses

Primary practice location

731 Bielenberg Dr Ste 102-104
Woodbury, MN 55125-1700

Mailing address

2300 Hastings Ave Apt 206
Newport, MN 55055-1853

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": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1861203614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HASTINGS AVE APT 206",
            "city": "NEWPORT",
            "state": "MN",
            "postal_code": "550551853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DR STE 102-104",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251700",
            "telephone_number": "612-435-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRICKEBERG",
        "first_name": "REGINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.

Verify at the official NPI Registry.