Individual provider Active NPI

Megan M Wollenburg, M.ED & BCBA

  • Behavior Analyst
  • Brooklyn, NY
National Provider Identifier
1922342385
Registry record updated Nov 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-08-4022 Issued in NY
Practice address
651 Vanderbilt St
Apt 7M
Brooklyn, NY 11218-1265
Phone
(650) 464-0761
NPI assigned
Nov 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2012

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 1-08-4022 NY Primary

Addresses

Primary practice location

651 Vanderbilt St
Apt 7M
Brooklyn, NY 11218-1265

Mailing address

651 Vanderbilt St
Apt 7M
Brooklyn, NY 11218-1265
Phone (650) 464-0761

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

NPI Registry JSON

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

{
    "created_epoch": "1353628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353628800000",
    "number": "1922342385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 VANDERBILT ST",
            "address_2": "APT 7M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181265",
            "telephone_number": "650-464-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 VANDERBILT ST",
            "address_2": "APT 7M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181265",
            "telephone_number": "650-464-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLENBURG",
        "first_name": "MEGAN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "M.ED & BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-23",
        "last_updated": "2012-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1-08-4022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2012; 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.