Individual provider Active NPI

Maria Dougherty, LBA, BCBA

  • Behavior Analyst
  • Hauppauge, NY
National Provider Identifier
1891495768
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
002558 Issued in NY
Practice address
750 Veterans Memorial Hwy Ste 100
Hauppauge, NY 11788-2943
Phone
(516) 284-1090
NPI assigned
Mar 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 002558 NY Primary

Addresses

Primary practice location

750 Veterans Memorial Hwy Ste 100
Hauppauge, NY 11788-2943

Mailing address

750 Veterans Memorial Hwy Ste 100
Hauppauge, NY 11788-2943

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

Networks

  • Healthfirst Medicare Network H9678

NPI Registry JSON

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1891495768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 VETERANS MEMORIAL HWY STE 100",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 VETERANS MEMORIAL HWY STE 100",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882943",
            "telephone_number": "516-284-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MARIA",
        "credential": "LBA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "002558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.