Active NPI
Elizabeth Smith
- Behavior Technician
- Uncasville, CT
National Provider Identifier
1932883170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 912 Norwich New London Tpke Ste 5
Uncasville, CT 06382-1908 - Phone
- (860) 847-0514
- Fax
- (860) 848-0523
- NPI assigned
- Jun 8, 2023
- 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
912 Norwich New London Tpke Ste 5
Uncasville, CT 06382-1908
Mailing address
912 Norwich New London Tpke Ste 5
Uncasville, CT 06382-1908
Phone (860) 847-0514
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creative Potential LLC | Current | Accepting new patients | |
| Creative Potential LLC | Current | Accepting new patients |
Locations
912 Norwich New London Tpke
Ste 5
Uncasville, CT 06382
Phone (860) 848-0514
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686182400000",
"number": "1932883170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 NORWICH NEW LONDON TPKE STE 5",
"city": "UNCASVILLE",
"state": "CT",
"postal_code": "063821908",
"telephone_number": "860-847-0514",
"fax_number": "860-848-0523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 NORWICH NEW LONDON TPKE STE 5",
"city": "UNCASVILLE",
"state": "CT",
"postal_code": "063821908",
"telephone_number": "860-847-0514",
"fax_number": "860-848-0523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ELIZABETH",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-08",
"last_updated": "2023-06-08",
"certification_date": "2023-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Uncasville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.