Active NPI
Crystal Danielle Wagner
- Behavior Technician
- Greenwell Springs, LA
National Provider Identifier
1861236267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 6685 Sullivan Rd
Greenwell Springs, LA 70739-3112 - Phone
- (225) 960-2403
- NPI assigned
- Jun 20, 2024
- Last updated
- Jun 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
6685 Sullivan Rd
Greenwell Springs, LA 70739-3112
Mailing address
6685 Sullivan Rd
Greenwell Springs, LA 70739-3112
Phone (225) 960-2403
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 |
|---|---|---|---|
| No Missing Pieces LLC | Behavior Technician | 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": "1718841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718841600000",
"number": "1861236267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6685 SULLIVAN RD",
"city": "GREENWELL SPRINGS",
"state": "LA",
"postal_code": "707393112",
"telephone_number": "225-960-2403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6685 SULLIVAN RD",
"city": "GREENWELL SPRINGS",
"state": "LA",
"postal_code": "707393112",
"telephone_number": "225-960-2403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "CRYSTAL",
"middle_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-20",
"last_updated": "2024-06-20",
"certification_date": "2024-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwell Springs, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.