Active NPI
Louise Southern
- Behavior Analyst
- Raleigh, NC
National Provider Identifier
1932500691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1095534
- Practice address
- 505 Oberlin Rd
Suite 230
Raleigh, NC 27605-1327 - Phone
- (919) 743-0204
- NPI assigned
- Sep 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1095534 | NC | Primary |
Addresses
Primary practice location
505 Oberlin Rd
Suite 230
Raleigh, NC 27605-1327
Mailing address
505 Oberlin Rd
Suite 230
Raleigh, NC 27605-1327
Phone (919) 743-0204
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3408612 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1095534 | NC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410393600000",
"number": "1932500691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 OBERLIN RD",
"address_2": "SUITE 230",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276051327",
"telephone_number": "919-743-0204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 OBERLIN RD",
"address_2": "SUITE 230",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276051327",
"telephone_number": "919-743-0204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHERN",
"first_name": "LOUISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-11",
"last_updated": "2014-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NC",
"license": "1095534",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3408612",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.