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ALYSSA PROCTOR
Complete NPI Record 1689406019
Behavior Technician in Beltsville, MD

NPI Status: Active since August 15, 2024

Contact Information

11720 BELTSVILLE DR # 500A15
BELTSVILLE, MD
ZIP 20705
Phone: (202) 790-8903
Fax: (301) 889-9735

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Provider Gender Code
  22. Healthcare Provider Taxonomy Code 1
  23. Healthcare Provider Primary Taxonomy Switch 1
  24. Is Sole Proprietor
  25. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1689406019. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1689406019
The country code in the location address of the provider being identified.
Entity Type Code: 1
The telephone number associated with the location address of the provider being identified.
The date the provider was assigned a unique identifier (assigned an NPI).
Provider First Name: ALYSSA
The date that a record was last updated or changed.
Provider First Line Business Mailing Address: 11720 BELTSVILLE DR # 500A15
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Provider Business Mailing Address City Name: BELTSVILLE
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 207053166
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
Provider Business Mailing Address Telephone Number: 2027908903
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 3018899735
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 11720 BELTSVILLE DR # 500A15
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: BELTSVILLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MD
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 207053166
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 2027908903
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3018899735
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 8/15/2024
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 8/15/2024
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 106S00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date: 8/15/2024