Individual provider Active NPI

Renee Marie McCroskey, RBT

  • Behavior Technician
  • Virginia Beach, VA
National Provider Identifier
1912599846
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RT21155620 Issued in VA
Practice address
293 Independence Blvd Ste 400
Virginia Beach, VA 23462-5461
Phone
(757) 490-4767
NPI assigned
Feb 11, 2021
Last updated
Feb 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X 45659 VA
Behavior Technician 106S00000X RT21155620 VA Primary

Addresses

Primary practice location

293 Independence Blvd Ste 400
Virginia Beach, VA 23462-5461

Mailing address

969 Aspen Dr
Virginia Beach, VA 23464-3938
Phone (757) 581-3974

Other names 1

  • Renee Marie Favire Former name

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
RT21155620VAMDBehavior Technician
45659VAMDRecreation Therapist

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1912599846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 ASPEN DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643938",
            "telephone_number": "757-581-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 INDEPENDENCE BLVD STE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625461",
            "telephone_number": "757-490-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCROSKEY",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "VA",
            "license": "45659",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "RT21155620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "FAVIRE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.