Active NPI
Jasmine Harrell-Broussard, BCBA
- Behavior Analyst
- Cypress, TX
National Provider Identifier
1013476423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 3419
- Practice address
- 12110 Huffmeister Rd
Cypress, TX 77429 - Phone
- (281) 894-1423
- NPI assigned
- Mar 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 3419 | TX | Primary |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
12110 Huffmeister Rd
Cypress, TX 77429
Mailing address
12101 Grant Forest Drive
Cypress, TX 77429
Phone (281) 223-5200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3419 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1013476423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12101 GRANT FOREST DRIVE",
"city": "CYPRESS",
"state": "TX",
"postal_code": "77429",
"telephone_number": "281-223-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12110 HUFFMEISTER RD",
"city": "CYPRESS",
"state": "TX",
"postal_code": "77429",
"telephone_number": "281-894-1423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL-BROUSSARD",
"first_name": "JASMINE",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-15",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "3419",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cypress, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.