1215235593 NPI number — KAREN A TOUSSAINT PLP, BCBA-D

Table of content: KAREN A TOUSSAINT PLP, BCBA-D (NPI 1215235593)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215235593 NPI number — KAREN A TOUSSAINT PLP, BCBA-D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOUSSAINT
Provider First Name:
KAREN
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PLP, BCBA-D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215235593
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1155 UNION CIR # 310919
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76203-5017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-369-5371
Provider Business Mailing Address Fax Number:
940-565-2467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
410 AVENUE C
Provider Second Line Business Practice Location Address:
360F CHILTON HALL
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-369-5371
Provider Business Practice Location Address Fax Number:
940-565-2467
Provider Enumeration Date:
03/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  427 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X , with the licence number: 1-12-10481 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10025287200 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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