Active NPI
Amanda Williams, BCBA, LBA
- Behavior Analyst
- Mystic, CT
National Provider Identifier
1932606928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA00123
- Practice address
- 4 Broadway Avenue Ext Unit 3
Mystic, CT 06355-2850 - Phone
- (860) 980-3233
- NPI assigned
- Apr 7, 2018
- Last updated
- Apr 7, 2018
- 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 | LBA00123 | RI | Primary |
Addresses
Primary practice location
4 Broadway Avenue Ext Unit 3
Mystic, CT 06355-2850
Mailing address
10 Brenden St
Westerly, RI 02891-1602
Phone (401) 212-6079
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 |
|---|---|---|---|
| LBA00123 | RI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523059200000",
"number": "1932606928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 BRENDEN ST",
"city": "WESTERLY",
"state": "RI",
"postal_code": "028911602",
"telephone_number": "401-212-6079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 BROADWAY AVENUE EXT UNIT 3",
"city": "MYSTIC",
"state": "CT",
"postal_code": "063552850",
"telephone_number": "860-980-3233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "AMANDA",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-07",
"last_updated": "2018-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "RI",
"license": "LBA00123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mystic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.