Active NPI
Brooke Lynn Jackson
- Behavior Technician
- Katy, TX
National Provider Identifier
1114606332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-272468
- Practice address
- 2710 N Mason Rd Ste 170
Katy, TX 77449-4180 - Phone
- (281) 505-9338
- NPI assigned
- Jul 14, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-23-272468 | Primary |
Addresses
Primary practice location
2710 N Mason Rd Ste 170
Katy, TX 77449-4180
Mailing address
2710 N Mason Rd Ste 170
Katy, TX 77449-4180
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1114606332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2710 N MASON RD STE 170",
"city": "KATY",
"state": "TX",
"postal_code": "774494180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 N MASON RD STE 170",
"city": "KATY",
"state": "TX",
"postal_code": "774494180",
"telephone_number": "281-505-9338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "BROOKE",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-14",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": "RBT-23-272468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.