Individual provider Active NPI

Stephanie Smith, BCBA

  • Behavior Analyst
  • Charlotte, NC
National Provider Identifier
1902374580
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-49145 Issued in NC
Practice address
2301 Crownpoint Executive Dr Ste E
Charlotte, NC 28227-6725
Phone
(704) 708-8314
Fax
(704) 708-8315
NPI assigned
Nov 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-21-49145 NC Primary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X RBT-18-69642 NC

Addresses

Primary practice location

2301 Crownpoint Executive Dr Ste E
Charlotte, NC 28227-6725

Mailing address

814 Tyvola Rd Ste 126
Charlotte, NC 28217-3539
Phone (980) 785-1113

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-18-69642NCMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1902374580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 TYVOLA RD STE 126",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173539",
            "telephone_number": "980-785-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 CROWNPOINT EXECUTIVE DR STE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282276725",
            "telephone_number": "704-708-8314",
            "fax_number": "704-708-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHANIE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "1-21-49145",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "RBT-18-69642",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.