Individual provider Active NPI

Skyler Dane Goodfellow, RBT

  • Behavior Technician
  • Owings Mills, MD
National Provider Identifier
1871307702
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-383706 Issued in MD
Practice address
500 Redland CT Ste 102
Owings Mills, MD 21117-3265
Phone
(443) 738-5110
NPI assigned
Feb 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 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 RBT-24-383706 MD Primary

Addresses

Primary practice location

500 Redland CT Ste 102
Owings Mills, MD 21117-3265

Mailing address

500 Redland CT Ste 102
Owings Mills, MD 21117-3265
Phone (443) 738-5110

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
RBT-24-383706MDMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1871307702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 REDLAND CT STE 102",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173265",
            "telephone_number": "443-738-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 REDLAND CT STE 102",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173265",
            "telephone_number": "443-738-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODFELLOW",
        "first_name": "SKYLER",
        "middle_name": "DANE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MD",
            "license": "RBT-24-383706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.