Individual provider Active NPI

Cassady Coco

  • Behavior Analyst
  • Hattiesburg, MS
National Provider Identifier
1114443579
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
190069 Issued in MS
Practice address
32 Millbranch Rd Ste 40
Hattiesburg, MS 39402-1673
Phone
(601) 255-5264
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-37190 MS
Behavior Analyst 103K00000X 190069 MS Primary

Addresses

Primary practice location

32 Millbranch Rd Ste 40
Hattiesburg, MS 39402-1673

Mailing address

18 Poplar Dr
Hattiesburg, MS 39402-9547

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

LicenseStateTypeSpecialty
190069MSMDBehavioral Analyst
RBT-17-37190MSMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1114443579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 POPLAR DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394029547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 MILLBRANCH RD STE 40",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021673",
            "telephone_number": "601-255-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCO",
        "first_name": "CASSADY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MS",
            "license": "RBT-17-37190",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MS",
            "license": "190069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.