Individual provider Active NPI

Molly Knudsen

  • Behavior Analyst
  • Fairfax, VA
National Provider Identifier
1871272880
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0133001060 Issued in VA
Practice address
10340 Democracy LN Ste 102B&103
Fairfax, VA 22030-2518
Phone
(877) 222-0399
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0133001060 VA Primary

Addresses

Primary practice location

10340 Democracy LN Ste 102B&103
Fairfax, VA 22030-2518

Mailing address

10340 Democracy LN Ste 102B&103
Fairfax, VA 22030-2518
Phone (877) 222-0399

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

State licenses

LicenseStateTypeSpecialty
0133001060VAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1871272880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10340 DEMOCRACY LN STE 102B&103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302518",
            "telephone_number": "877-222-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10340 DEMOCRACY LN STE 102B&103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302518",
            "telephone_number": "877-222-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSEN",
        "first_name": "MOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.