Individual provider Active NPI

Stephanie Mattoccia, RBT

  • Behavior Technician
  • Mount Laurel, NJ
National Provider Identifier
1992208391
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-17-33724 Issued in NJ
Practice address
801 Birchfield Dr
Mount Laurel, NJ 08054-4015
Phone
(484) 681-2170
NPI assigned
Mar 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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-17-33724 NJ Primary

Addresses

Primary practice location

801 Birchfield Dr
Mount Laurel, NJ 08054-4015

Mailing address

583 Shoemaker Rd Ste 230
King of Prussia, PA 19406-4201
Phone (484) 681-2170

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-17-33724NJMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1992208391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 SHOEMAKER RD STE 230",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064201",
            "telephone_number": "484-681-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BIRCHFIELD DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544015",
            "telephone_number": "484-681-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOCCIA",
        "first_name": "STEPHANIE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NJ",
            "license": "RBT-17-33724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.

Verify at the official NPI Registry.