Active NPI
Risa Joy Clow, RBT
- Behavior Technician
- MC Lean, VA
National Provider Identifier
1962073379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 15-5701-22489
- Practice address
- 1651 Old Meadow Rd
MC Lean, VA 22102-4311 - Phone
- (703) 506-0123
- NPI assigned
- Jul 7, 2021
- 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 | 15-5701-22489 | VA | Primary |
Addresses
Primary practice location
1651 Old Meadow Rd
MC Lean, VA 22102-4311
Mailing address
43286 Swampfox CT
Ashburn, VA 20147-5309
Phone (160) 925-4343
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 |
|---|---|---|---|
| 15-5701-22489 | VA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625616000000",
"number": "1962073379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43286 SWAMPFOX CT",
"city": "ASHBURN",
"state": "VA",
"postal_code": "201475309",
"telephone_number": "160-925-4343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 OLD MEADOW RD",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221024311",
"telephone_number": "703-506-0123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOW",
"first_name": "RISA",
"middle_name": "JOY",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-07",
"last_updated": "2021-07-07",
"certification_date": "2021-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "15-5701-22489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.