Kizztophe Asuncion, CBT

Individual provider Active NPI Behavior Analyst · Covington, WA

NPI 1144738600 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1144738600
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
CB60810778 (WA)
Practice address
27023 164TH Ave SE
Covington, WA 98042-8241
Phone
(253) 639-7146
NPI assigned
Jan 18, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CB60810778WAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Mindsource Center, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X CB60810778 WA Yes

Addresses

Primary practice location

27023 164TH Ave SE
Covington, WA 98042-8241

Mailing address

27023 164TH Ave SE
Covington, WA 98042-8241
Phone (253) 639-7146

Other practice location 1

27023 164th Ave SE
Covington, WA 98042-8241
Phone (253) 639-7146

Other providers in Covington, WA

All providers in Covington, WA · Behavior Analyst in Washington

Sources for this page

Verify at the official NPI Registry.