Individual provider Active NPI

Stephanie Young, BCBA

  • Behavior Analyst
  • Elizabeth City, NC
National Provider Identifier
1891298378
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-45030
Practice address
1431B Weeksville Rd
Elizabeth City, NC 27909-8431
Phone
(252) 677-5100
Fax
(252) 677-5110
NPI assigned
Mar 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 1744691 CA
Behavior Analyst 103K00000X 1-20-45030 Primary

Addresses

Primary practice location

1431B Weeksville Rd
Elizabeth City, NC 27909-8431

Mailing address

1431B Weeksville Rd
Elizabeth City, NC 27909-8431
Phone (252) 677-5100

Other practice location 1

510 Whispering Wind Dr Ste 110
Tracy, CA 95377-8119
Phone (209) 832-7756

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
1744691CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Autism Services, Inc. Behavior Analyst CurrentSince Sep 6, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1891298378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431B WEEKSVILLE RD",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279098431",
            "telephone_number": "252-677-5100",
            "fax_number": "252-677-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431B WEEKSVILLE RD",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279098431",
            "telephone_number": "252-677-5100",
            "fax_number": "252-677-5110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Whispering Wind Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Tracy",
            "state": "CA",
            "postal_code": "953778119",
            "country_code": "US",
            "telephone_number": "209-832-7756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "STEPHANIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "1744691",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-20-45030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.