STEFANIE CULLUM (NPI# 1770115875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770115875 |
| Entity Type | Individual |
| Full Name | STEFANIE CULLUM |
| Practice Address |
65 Thomas Johnson Dr Frederick MD 21702-4371 |
| Practice Telephone | 3016623808 |
| Practice Fax Number | 3016623808 |
| Mailing Telephone | 3016623808 |
| Mailing Fax Number | 3016623808 |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
65 THOMAS JOHNSON DR |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376546994 | Regina Kundell | Nurse Practitioner | 65 Thomas Johnson Dr, C, Frederick, MD 21702-4371 | 2005-05-27 |
| 1871137505 | Alyssa Heflin | Behavior Technician | 65 Thomas Johnson Dr, Frederick, MD 21702-4371 | 2019-11-06 |
| 1144874413 | Rebecca Kucevic | Behavior Technician | 65 Thomas Johnson Dr, Frederick, MD 21702-4371 | 2019-07-25 |
| 1205288271 | Christina Wagoner | Counselor | 65 Thomas Johnson Dr, Suite A, Frederick, MD 21702-4371 | 2016-07-01 |
| 1649637554 | Laren Anderson | Counselor | 65 Thomas Johnson Dr, #a Attn: Laren Anderson, Frederick, MD 21702-4371 | 2016-01-22 |
| 1366838617 | Kelsey Sue Eaton | Community Health Worker | 65 Thomas Johnson Dr, Suite A, Frederick, MD 21702-4371 | 2015-04-14 |
| 1871986075 | Sam Specht | Community Health Worker | 65 Thomas Johnson Dr, Suite A, Frederick, MD 21702-4371 | 2015-03-12 |
| 1407247638 | Emma Rivera | Community Health Worker | 65 Thomas Johnson Dr, Ste A, Frederick, MD 21702-4371 | 2015-02-10 |
| 1255746020 | Todd Phillips | Physical Therapist | 65 Thomas Johnson Dr, Suite D, Frederick, MD 21702-4371 | 2014-06-30 |
| 1407278575 | Rachel Ayres | Community Health Worker | 65 Thomas Johnson Dr, Suite A, Frederick, MD 21702-4371 | 2014-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
| Find all providers in zip 21702 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144832791 | Sadie Reece Hamrick | Behavior Technician | 149 Willowdale Dr Apt 13, Frederick, MD 21702-1170 | 2020-08-17 |
| 1740891845 | Airiana Bryant | Behavior Technician | 2426 Huntwood Ct, Frederick, MD 21702-3184 | 2020-08-12 |
| 1104434067 | Michelle Jackson | Behavior Technician | 6961 Rooks Ct Apt 305, Frederick, MD 21703-2781 | 2020-07-16 |
| 1720696800 | Brice L Drabo | Behavior Technician | 1948 Timber Grove Rd, Frederick, MD 21702-3099 | 2020-07-15 |
| 1790303154 | Edward Calabro Dalkiewicz | Behavior Technician | 120 Willowdale Dr Apt 31, Frederick, MD 21702-1040 | 2020-07-10 |
| 1487284006 | Danielle James | Behavior Technician | 5300 Westview Dr, Frederick, MD 21703-8339 | 2020-01-23 |
| 1366081713 | Emma I Mcneil | Behavior Technician | 6005 Alynwood Dr, Frederick, MD 21704-6730 | 2020-01-02 |
| 1043858269 | Morgan Sara Kidwell | Behavior Technician | 808 Stratford Way Apt E, Frederick, MD 21701-9182 | 2019-12-18 |
| 1679116222 | Hope Marie Harley | Behavior Technician | 204 Ashfield Ct, Frederick, MD 21702-8711 | 2019-10-25 |
| 1255973038 | Jasmyn T. Ajlouny | Behavior Technician | 22 W 7th St, Frederick, MD 21701-4502 | 2019-10-12 |
| Find all providers in FREDERICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.