Michael J Thomas Enterprise LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

MICHAEL J THOMAS ENTERPRISE LLC

Doing business as

ABC Behavior

Practice address

2529 19TH St
Lake Charles, LA 70601-8143

Phone

(337) 377-7667

NPI assigned

Dec 17, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Thomas

Title

Ceo

Phone

(337) 377-7667

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ABC Behavior Doing business as

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1043858343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 19TH ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018143",
            "telephone_number": "337-377-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 19TH ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018143",
            "telephone_number": "337-377-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J THOMAS ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-377-7667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20-07179114",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC Behavior",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Behavior Analyst in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Behavior Analyst in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.