Individual provider Active NPI

Hannah Bickel, BEHAVIOR TECHNICIAN

  • Behavior Technician
  • Salem, OR
National Provider Identifier
1972233377
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
ABA-IN-10217912 Issued in OR
Practice address
1174 Cornucopia St NW Ste 110
Salem, OR 97304-3193
Phone
(800) 273-4292
Fax
(714) 596-6274
NPI assigned
Jun 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X ABA-IN-10217912 OR Primary

Addresses

Primary practice location

1174 Cornucopia St NW Ste 110
Salem, OR 97304-3193

Mailing address

11037 Warner Ave # 339
Fountain Valley, CA 92708-4007
Phone (800) 273-4292

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

LicenseStateTypeSpecialty
ABA-IN-10217912ORMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Footprints Behavior Interventions CurrentSince Jul 24, 2022 Accepting new patients
Footprints Behavioral Interventions, Inc. Behavior Technician PastSince Jun 21, 2022 Accepting new patients

Locations

11037 Warner Ave
#339
Fountain Valley, CA 92708
Phone (714) 848-8319

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": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1972233377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11037 WARNER AVE # 339",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "800-273-4292",
            "fax_number": "714-596-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 CORNUCOPIA ST NW STE 110",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043193",
            "telephone_number": "800-273-4292",
            "fax_number": "714-596-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKEL",
        "first_name": "HANNAH",
        "credential": "BEHAVIOR TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OR",
            "license": "ABA-IN-10217912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.