Individual provider Active NPI

Soreylie Vazquez-Marrero

  • Behavior Technician
  • Elizabethtown, KY
National Provider Identifier
1972296002
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-270985 Issued in KY
Practice address
1609 N Dixie Ave Ste 114
Elizabethtown, KY 42701-7494
Phone
(270) 215-5959
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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 RBT-23-270985 KY Primary

Addresses

Primary practice location

1609 N Dixie Ave Ste 114
Elizabethtown, KY 42701-7494

Mailing address

1321 Murfreesboro Pike Ste 410
Nashville, TN 37217-2665
Phone (615) 696-6761

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
RBT-23-270985KYMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1972296002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 MURFREESBORO PIKE STE 410",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372172665",
            "telephone_number": "615-696-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 N DIXIE AVE STE 114",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017494",
            "telephone_number": "270-215-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ-MARRERO",
        "first_name": "SOREYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "KY",
            "license": "RBT-23-270985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.